Clinical features of midzonal iris pigment epithelial cysts: surprising findings revealed by ultrasound biomicroscopy.

IF 2.4 3区 医学 Q2 OPHTHALMOLOGY
Jonathan T Regenold, Zélia M Corrêa, James J Augsburger
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引用次数: 0

Abstract

Purpose: Midzonal iris pigment epithelial (IPE) cysts are typically asymptomatic but can pose a differential diagnostic challenge by mimicking ciliary body melanoma. We conducted a case series study of the clinical characteristics of these iris cysts, particularly their shapes and sizes and associated lesions revealed by ultrasound biomicroscopy (UBM).

Methods: Charts of patients with midzonal IPE cysts encountered by one or more of the authors were reviewed retrospectively. Pertinent demographic information and clinical data about these patients and their cysts were abstracted.

Results: 69 patients were identified. At initial diagnosis, patients ranged in age from 14.8 to 89.5 years (median: 66.0 years). Only one patient was < 30 years old at diagnosis. 38 patients (55.1%) were female. 74 eyes (39 right, 35 left) contained one or more clinically identified midzonal IPE cysts. The cysts involved the right eye alone in 34 (49.3%), the left eye alone in 30 (43.5%), and both eyes in 5 (7.2%) patients. The midzonal IPE cysts were located most often inferotemporally (51.4%) and second most often temporally (23.0%). UBM imaging had been performed on 44 of the 74 affected eyes. The median largest basal diameter of the midzonal IPE cysts evaluated by UBM was 4.5 mm (extremes: 1.5 to 13 mm), and the median height of these cysts was 1.5 mm (extremes: 0.6 to 6 mm). The largest lesion was a complete ring cyst. All 3 UBM-evaluated eyes that appeared by slit lamp biomicroscopy to have two or more distinct midzonal IPE cysts were shown by UBM to have a single sausage or kidney-bean shaped partial ring cyst with radial folds between the lobules and not separate multiple cysts. UBM imaging also identified peripheral IPE cysts in 32 of 44 evaluated eyes (72.7%).

Conclusions: Our case series confirmed previously reported findings regarding age at diagnosis and most common locations of midzonal IPE cysts. However, our UBM images revealed that at least some IPE cysts identified by slit lamp biomicroscopy as multifocal are partial ring cysts with radial folds in the cyst wall between lobules and not true independent multiple cysts.

Key messages: What is known Midzonal IPE cysts occur most often unilaterally and inferotemporally. Midzonal IPE cysts are frequently associated with peripheral IPE cysts. What is new UBM imaging of eyes with two-clinically detected IPE cysts showed that they were confluent as opposed to separate cysts. The median largest basal diameter of midzonal IPE cysts evaluated by UBM was 4.5 mm (extremes: 1.5 and 13 mm). The median height of midzonal IPE cysts evaluated by UBM was 1.5 mm (extremes: 0.6 and 6 mm).

中区虹膜色素上皮囊肿的临床特征:超声生物显微镜的惊人发现。
目的:中带状虹膜色素上皮(IPE)囊肿通常无症状,但会因模仿睫状体黑色素瘤而给鉴别诊断带来挑战。我们对这些虹膜囊肿的临床特征,尤其是其形状、大小以及超声生物显微镜(UBM)显示的相关病变进行了病例系列研究:方法:对一位或多位作者遇到的中轴IPE囊肿患者的病历进行回顾性研究。结果:共发现 69 例患者:结果:共发现 69 例患者。初步诊断时,患者的年龄从 14.8 岁到 89.5 岁不等(中位数:66.0 岁)。只有一名患者得出结论:我们的病例系列证实了之前报道的有关IPE中段囊肿的诊断年龄和最常见位置的研究结果。然而,我们的 UBM 图像显示,至少有一些经裂隙灯生物显微镜确定为多灶的 IPE 囊肿是部分环状囊肿,囊壁在小叶之间有径向皱褶,而不是真正独立的多发囊肿:已知的情况 IPE中区囊肿多发生于单侧和颞下部。中轴IPE囊肿常与周围IPE囊肿伴发。新发现 对有两个临床检测到的IPE囊肿的眼球进行UBM成像显示,它们是融合的,而不是独立的囊肿。经 UBM 评估,中轴 IPE 囊肿的最大基底直径中值为 4.5 毫米(极值:1.5 毫米和 13 毫米)。UBM 评估的中轴 IPE 囊肿的中位高度为 1.5 毫米(极值:0.6 和 6 毫米)。
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来源期刊
CiteScore
5.40
自引率
7.40%
发文量
398
审稿时长
3 months
期刊介绍: Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.
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