[Plateau iris-like configuration resulting from numerous iridociliary cysts].

INTRODUCTION

The clinical diagnosis of plateau iris most often remains a suspected diagnosis in absence of complementary imaging tests. We report the case of a plateau-like iris configuration resulting from numerous iridociliary cysts and the diagnostic value of ultrasound biomicroscopy (UBM).

OBSERVATION

A 35-year-old Caucasian woman with a family history of PAOG presented asymptomatic high intraocular pressure (IOP) (26mmHg RE, 17mmHg LE). She had a normal deep anterior chamber, a narrow iridocorneal angle with sectoral abnormal insertion of the iris and a normal fundus. Laser peripheral iridotomy was performed. One year later, the patient presented again with elevated IOP in the right eye (25mmHg); hypotensive monotherapy was prescribed. Later she reported eye pain in the evening. Gonioscopy found an iridocorneal contact covering more than 200 degrees in the right eye, with less extensive coverage in the left eye. The hypothesis of plateau iris-like syndrome was suggested because of the failure of the iridotomy and UBM was performed. This confirmed the diagnosis of plateau iris configuration secondary to numerous ciliary body cysts.

DISCUSSION

UBM provides great diagnostic assistance, superior to anterior segment OCT in the diagnosis of plateau iris syndrome, particularly in imaging the ciliary body.

CONCLUSION

The numerous iridociliary cysts can imitate iris plateau syndrome, which explains aggravation over time, depending on their formation. UBM is a highly valuable tool for the diagnosis and the follow-up of this pathology.