Mayro Eileen L, Surakiatchanukul Thamolwan, Shields Jerry A, Shields Carol L
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA.
Oman J Ophthalmol. 2018 May-Aug;11(2):161-163. doi: 10.4103/ojo.OJO_226_2017.
A 49-year old male with corrected visual acuity of 20/25 OD and 20/20 OS was found to have an asymptomatic dark iris mass OD with suspicion for ciliary body melanoma. Predilation slit-lamp biomicroscopy revealed a well-circumscribed brown round mass arising posterior to the iris, presumably from the ciliary body; however, postdilation demonstrated an extended fusiform mass of the iris pigment epithelium (IPE). By anterior segment imaging, the well-circumscribed IPE mass was cystic and measured 1440 microns in thickness peripherally predilation and 300 microns in thickness postdilation. There was no solid IPE or ciliary body component. A diagnosis of midzonal IPE cyst was rendered and observation advised. Clinical features and anterior segment imaging can assist in differentiation of midzonal IPE cyst from adenoma and ciliary body melanoma. The diagnostic methodology described in this paper can be used by ophthalmologists to promptly rule out underlying melanoma.
一名49岁男性，右眼矫正视力为20/25，左眼矫正视力为20/20，被发现右眼有一个无症状的深色虹膜肿物，怀疑为睫状体黑色素瘤。散瞳前裂隙灯生物显微镜检查显示，虹膜后方有一个边界清晰的褐色圆形肿物，推测起源于睫状体；然而，散瞳后显示为虹膜色素上皮（IPE）的梭形肿物。通过眼前段成像，边界清晰的IPE肿物呈囊性，散瞳前周边厚度为1440微米，散瞳后厚度为300微米。没有实性IPE或睫状体成分。诊断为中区IPE囊肿，并建议进行观察。临床特征和眼前段成像有助于中区IPE囊肿与腺瘤和睫状体黑色素瘤的鉴别。本文所述的诊断方法可供眼科医生用于迅速排除潜在的黑色素瘤。
