Atlas of Ophthalmology

Suspected Melanocytoma of Iris (Colour Photography Anterior Segment, Ultrasound Biomicroscopy)

Iris and Ciliary Body -> Tumors/Neoplasmas -> Benign
Patient: 78 years of age, male, BCVA 0.2, IOP 19mmHg Ocular Medical History: annual control of pigmented iris process, over 15 years no significant change in size. General Medical History: no other tumors. Maint complaint: slow loss of visual acuity. Purpose: to present time course over 5 years of pigmented iridal process. Methods: colour photography, ultrasound biomicroscopy. Findings: Colour Photography Anterior Segment in 2011: melanotic tumor of the iris and the anterior chamber angle, size 2mm x 3.2mm. Colour Photography Anterior Segment in 2015: melanotic tumor of the iris and the anterior chamber angle, size 2mm x 3.2mm . Comparing Colour Photography Anterior Segment of 2011and 2015: stationary melanotic tumor of the iris and the anterior chamber angle. Ultrasound biomicroscopy in 2011: solid iris lesion with a size of 3.2mm x 1.8 mm. Ultrasound biomicroscopy in 2011: solid iris lesion with a size of 3.4mm x 1.9 mm Comparing Ultrasound biomicroscopy of 2011 and 2015: stationary solid tumor of the iris, no change in size. Discussion: Iris melanocytoma is a rare variant of iris nevus with typical clinical features. Although the tumor is benign, it can spread to the surrounding structures, causing glaucoma and giving an erroneous impression of melanoma. Iris melanocytoma presents as a darkly-pigmented iris nodule with mossy, irregular surface. Iris melanocytoma usually has been considered to be a relatively stationary lesion. Demirci et al. (1) found that growth occurred in 23% of the patients at 5 years and 48% at 10 years. Literature: (1) Hakan Demirci, Arman Mashayekhi, Carol L. Shields, Ralph C. Eagle Jr, Jerry A. Shields. Iris melanocytoma: Clinical features and natural course in 47 cases. American Journal of Ophthalmology , Volume 139, Issue 3, March 2005, 468–475

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