Allegrini Davide, Montesano Giovanni, Pece Alfredo
Case Rep Ophthalmol. 2016 Sep 30;7(3):172-178. doi: 10.1159/000450572. eCollection 2016 Sep-Dec.
Iris nevus is common: 6% of patients with suspected iris melanoma have lesions other than melanoma, and 36% of them are nevi. Iris nevus turns into melanoma in approximately 8% of cases at a mean of 15 years. This case report provides the first description of an iris tumor examined with iris optical coherence tomography angiography (OCTA) compared to iris fluorescein angiography (IFA). A 60-year-old man with a diagnosis of iris nevus in the left eye was referred to our department for IFA and iris OCTA. The iris vasculature in IFA was visible only in the early phases, but not clearly. OCTA, however, gave visualization of the vascular network and very precisely defined the vessels of the whole lesion, except for the pupillary portion, which was masked by superficial pigment accumulations. IFA and iris OCTA can add information about the vascular architecture compared to slit-lamp biomicroscopy, ultrasound biomicroscopy, and anterior-segment OCT. However, IFA is time-consuming and invasive and can - very occasionally - cause serious adverse reactions. In contrast, OCTA defines the texture of the iris vasculature better. In conclusion, OCTA is a new method, easy to execute, needing no dye injection, and provides useful information on the vascular network of iris lesions. It could therefore be helpful in the diagnosis and follow-up of these lesions.
6%疑似虹膜黑色素瘤的患者有除黑色素瘤以外的病变，其中36%为痣。虹膜痣在大约8%的病例中会在平均15年的时间里转变为黑色素瘤。本病例报告首次描述了与虹膜荧光血管造影（IFA）相比，使用虹膜光学相干断层扫描血管造影（OCTA）检查的虹膜肿瘤。一名诊断为左眼虹膜痣的60岁男性被转诊至我科进行IFA和虹膜OCTA检查。IFA中的虹膜血管仅在早期可见，但不清晰。然而，OCTA能够显示血管网络，并非常精确地界定整个病变的血管，除了被表面色素沉着掩盖的瞳孔部分。与裂隙灯生物显微镜检查、超声生物显微镜检查和眼前节OCT相比，IFA和虹膜OCTA可以提供有关血管结构的信息。然而，IFA耗时且具有侵入性，并且非常偶尔会引起严重的不良反应。相比之下，OCTA能更好地界定虹膜血管的纹理。总之，OCTA是一种新方法，易于实施，无需注射染料，并能提供有关虹膜病变血管网络的有用信息。因此，它可能有助于这些病变的诊断和随访。
