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Klin Monbl Augenheilkd 2007; 224(4): 324-327
DOI: 10.1055/s-2007-962951
Kasuistik

© Georg Thieme Verlag KG Stuttgart · New York

Ultrasound Biomicroscopy Evaluation of Angle Closure in a Patient with Multiple and Bilateral Iridociliary Cysts

Ultraschallbiomikroskopische Untersuchung des Kammerwinkelblocks einer Patientin mit multiplen und beidseitigen IridoziliarzystenJ. M. Katsimpris1 , I. K. Petropoulos2 , G. Sunaric-Mégevand3
  • 1Department of Ophthalmology, General Hospital of Patras “O Agios Andreas”, Patras, Greece (Chairman: Dionysios Feretis, M. D.)
  • 2Department of Ophthalmology, University Hospitals of Geneva, Geneva, Switzerland (Chairman: Prof. Avinoam B. Safran)
  • 3Fondation Rothschild, Clinique Générale Beaulieu, Geneva, Switzerland
Further Information

Publication History

received: 15.9.2006

accepted: 1.12.2006

Publication Date:
26 April 2007 (online)

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Zusammenfassung

Hintergrund: Beschreibung der ultraschallbiomikroskopischen Ergebnisse eines Falles mit beidseitigen multilobulären primären Iridoziliarzysten, die sich als chronisches Winkelblockglaukom präsentieren. Anamnese und Befund: Bei einer 82-jährigen Patientin wurde in einem Tertiär-Augenzentrum eine gründliche Untersuchung des allmählichen Verlusts der Gesichtsfelder sowie der Papillen vorgenommen. Die klinische Beurteilung der Patientin ergab ein Winkelblockglaukom und einer Katarakt in beiden Augen. In der ultraschallbiomikroskopischen Untersuchung wurden beidseitig multilobuläre Iridoziliarzysten festgestellt. Die beidseitig vorliegenden multiplen Iridoziliarzysten verursachen eine Iriselevation und demzufolgenden Kammerwinkelblock. Schlussfolgerungen: Primäre Iridoziliarzysten erreichen selten eine Größe, die den Kammerwinkel beeinträchtigt. Sie gelten in der Regel als gutartige und stationäre Läsionen. Mit der Ultraschallbiomikroskopie steht den Augenärzten heute ein höchst wertvolles Instrument für die Diagnose und Überwachung dieser Läsionen zur Verfügung.

Abstract

Purpose: The aim of this study was to describe the findings of ultrasound biomicroscopy (UBM) in a case with bilateral, multilobulate primary iridociliary cysts presenting as chronic angle-closure glaucoma. History and Signs: An 82-year-old woman was admitted to a tertiary ophthalmological centre for a thorough exploration of the gradual deterioration of her visual fields and optic discs. Clinical evaluation of the patient revealed angle-closure glaucoma and cataract in both eyes. The use of UBM disclosed the presence of bilateral, multilobulate iridociliary cysts in all quadrants. The presence of multiple and bilateral iridociliary cysts was the cause of iris anterior displacement and the subsequent angle closure in this patient. Conclusions: Primary iridociliary cysts may rarely progress to a size that can compromise the angle. They are usually considered as benign and stationary lesions. The advent of UBM is an invaluable tool for the contemporary ophthalmologist in order to set the diagnosis and follow the evolution of those lesions.

Schlüsselwörter

Iridoziliarzysten - Winkelblockglaukom - Ultraschallbiomikroskopie

Key words

iridociliary cysts - angle-closure glaucoma - ultrasound biomicroscopy

References

  • 1 Albert D L, Brownstein S, Kattleman B S. Mucogenic glaucoma caused by an epithelial cyst of the iris stroma.  Am J Ophthalmol. 1992;  114 222-224
    PubMedGoogle Scholar
  • 2 Azuara-Blanco A, Spaeth G L, Araujo S V. et al . Plateau iris syndrome associated with multiple ciliary body cysts. Report of three cases.  Arch Ophthalmol. 1996;  114 666-668
    PubMedGoogle Scholar
  • 3 Chandler P A, Braconier H E. Spontaneous intra-epithelial cysts of iris and ciliary body with glaucoma.  Am J Ophthalmol. 1958;  45 64-74
    PubMedGoogle Scholar
  • 4 Chandler P A, Grant W M. Angle closure glaucoma due to multiple cysts of iris and ciliary body. Chandler PA, Grant WM Glaucoma Philadelphia; PA: Lea & Febiger 1979 2nd edn: 187-189
    Google Scholar
  • 5 Coleman D J, Woods S, Rondeau M J. et al . Ophthalmic ultrasonography.  Radiol Clin North Am. 1992;  30 1105-1114
    PubMedGoogle Scholar
  • 6 Cronemberger S, Ferreira D M, Diniz Filho A. et al . Prevalência de cistos iridociliares em exames de biomicroscopia ultra-sônica.  Arq Bras Oftalmol. 2006;  69 471-475
    PubMedGoogle Scholar
  • 7 Fine N, Pavlin C J. Primary cysts in the iridociliary sulcus: ultrasound biomicroscopic features of 210 cases.  Can J Ophthalmol. 1999;  34 325-329
    PubMedGoogle Scholar
  • 8 Küchle M, Green W R. Epithelial ingrowth: a study of 207 histopathologically proven cases.  Ger J Ophthalmol. 1996;  5 211-223
    PubMedGoogle Scholar
  • 9 Kunimatsu S, Araie M, Ohara K. et al . Ultrasound biomicroscopy of ciliary body cysts.  Am J Ophthalmol. 1999;  127 48-55
    CrossrefPubMedGoogle Scholar
  • 10 Liebmann J M, Tello C, Chew S J. et al . Prevention of blinking alters iris configuration in pigment dispersion syndrome and in normal eyes.  Ophthalmology. 1995;  102 446-455
    PubMedGoogle Scholar
  • 11 Lois N, Shields C L, Shields J A. et al . Cavitary melanoma of the ciliary body. A study of eight cases.  Ophthalmology. 1998;  105 1091-1098
    CrossrefPubMedGoogle Scholar
  • 12 Makley T A, King G L. Multiple cysts of the iris and ciliary body simulating a malignant melanoma.  Trans Am Acad Ophthalmol Otolaryngol. 1958;  62 441-443
    PubMedGoogle Scholar
  • 13 Marigo F A, Esaki Jr K, Finger P T. et al . Differential diagnosis of anterior segments cysts by ultrasound biomicroscopy.  Ophthalmology. 1999;  106 2131-2135
    CrossrefPubMedGoogle Scholar
  • 14 Nouby-Mahmoud G, Silverman R H, Coleman D J. Using high-frequency ultrasound to characterize intraocular foreign bodies.  Ophthalmic Surg. 1993;  24 94-99
    PubMedGoogle Scholar
  • 15 Pavlin C J, Easterbrook M, Hurwitz J J. et al . Ultrasound biomicroscopy in the assessment of anterior scleral disease.  Am J Ophthalmol. 1993;  116 628-635
    PubMedGoogle Scholar
  • 16 Pavlin C J, Harasiewicz K, Sherar M D. et al . Clinical use of ultrasound biomicroscopy.  Ophthalmology. 1991;  98 287-295
    CrossrefPubMedGoogle Scholar
  • 17 Pavlin C J, Mc Whae J A, McGowan H D. et al . Ultrasound biomicroscopy of anterior segment tumors.  Ophthalmology. 1992;  99 1220-1228
    PubMedGoogle Scholar
  • 18 Pavlin C J, Ritch R, Foster F S. Ultrasound biomicroscopy in plateau iris syndrome.  Am J Ophthalmol. 1992;  113 390-395
    PubMedGoogle Scholar
  • 19 Pavlin C J, Rootman D, Arshinoff S. et al . Determination of haptic position of transsclerally fixated posterior chamber intraocular lenses by ultrasound biomicroscopy.  J Cataract Refract Surg. 1993;  19 573-577
    PubMedGoogle Scholar
  • 20 Pavlin C J, Sherar M D, Foster F S. Subsurface ultrasound microscopic imaging of the intact eye.  Ophthalmology. 1990;  97 244-250
    PubMedGoogle Scholar
  • 21 Perera C A. Epithelium in the anterior chamber of the eye after operation and injury.  Am J Ophthalmol. 1938;  21 605-617
    PubMedGoogle Scholar
  • 22 Potash S D, Tello C, Liebmann J. et al . Ultrasound biomicroscopy in pigment dispersion syndrome.  Ophthalmology. 1994;  101 332-339
    PubMedGoogle Scholar
  • 23 Reminick L R, Finger P T, Ritch R. et al . Ultrasound biomicroscopy in the diagnosis and management of anterior segment tumors.  J Am Optom Assoc. 1998;  69 575-582
    PubMedGoogle Scholar
  • 24 Rummelt V, Naumann G O. Cystic epithelial ingrowth after goniotomy for congenital glaucoma. A clinicopathologic report.  J Glaucoma. 1997;  6 353-356
    PubMedGoogle Scholar
  • 25 Shields J A, Kline M W, Augsburger J J. Primary iris cysts: a review of the literature and report of 62 cases.  Br J Ophthalmol. 1984;  68 152-166
    CrossrefPubMedGoogle Scholar
  • 26 Tanihara H, Akita J, Honjo M. et al . Angle closure caused by multiple, bilateral iridociliary cysts.  Acta Ophthalmol Scand. 1997;  75 216-217
    PubMedGoogle Scholar
  • 27 Tello C, Chi T, Shepps G. et al . Ultrasound biomicroscopy in pseudophakic malignant glaucoma.  Ophthalmology. 1993;  100 1330-1334
    PubMedGoogle Scholar
  • 28 Thomas R, Mulligan N, Aylward G W. et al . Angle closure glaucoma due to iris and ciliary body cysts.  Aust N Z J Ophthalmol. 1989;  17 317-319
    PubMedGoogle Scholar
  • 29 Vela A, Rieser J C, Campbell D G. The heredity and treatment of angle-closure glaucoma secondary to iris and ciliary body cysts.  Ophthalmology. 1984;  91 332-337
    PubMedGoogle Scholar
  • 30 Wintersteiner H. Ueber idiopathische Pigmentzysten der Iris.  Klin Monatsbl Augenheilkd. 1906;  44 (II) 297-298
    PubMedGoogle Scholar
  • 31 Yanoff M, Zimmerman L E. Pseudomelanoma of anterior chamber caused by implantation of iris pigment epithelium.  Arch Ophthalmol. 1965;  74 302-305
    PubMedGoogle Scholar

John M. Katsimpris, M. D.

Ritsou & Empirikou Str. 73

Patras 26335

Greece

Phone: ++30/2 61/0 64 34 97

Fax: ++30/2 61/0 64 34 97

Email: jkatsimpris@yahoo.com

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