Finger P T, McCormick S A, Lombardo J, Tello C, Ritch R
Department of Ophthalmology, New York (NY) Eye and Ear Infirmary, USA.
Arch Ophthalmol. 1995 Jun;113(6):777-80. doi: 10.1001/archopht.1995.01100060103042.
We describe the clinical presentation, high-frequency ultrasound biomicroscopic characteristics, and pathologic findings associated with a conjunctival inclusion cyst within the iris. The patient had undergone an uncomplicated extracapsular cataract extraction with posterior chamber intraocular lens insertion 9 months prior to presenting with a progressively enlarging iris mass. A clinical examination revealed a solid-appearing white tumor within the midiris stroma, accompanied by limbal-conjunctival hyperemia and anterior chamber inflammation. Ultrasound biomicroscopy revealed an egg-shaped solid iris stromal tumor that displaced the pigment epithelium. The mass was composed of three concentric layers of different echogenicity: a moderately reflective mantle, a less reflective middle zone, and a hyperreflective core. Within 3 days of initiation of topical corticosteroid therapy (prednisolone acetate, 0.5 mg per drop four times daily), the tumor enlarged and induced a plasmoid aqueous and a hypopyon. Histopathologic study revealed a conjunctival inclusion cyst with evidence of acute and chronic inflammation. We have found that the diagnosis of epithelial inclusion cyst within the iris can be aided by an ultrasound evaluation. This case also suggests that it may be preferable to excise these tumors prior to topical corticosteroid treatment.
我们描述了与虹膜内结膜包涵囊肿相关的临床表现、高频超声生物显微镜特征及病理结果。该患者在出现逐渐增大的虹膜肿物9个月前接受了无并发症的囊外白内障摘除术及后房型人工晶状体植入术。临床检查发现虹膜基质中部有一个看似实性的白色肿物，伴有角膜缘结膜充血及前房炎症。超声生物显微镜检查显示一个椭圆形实性虹膜基质肿物，使色素上皮移位。肿物由三层不同回声性的同心层组成：一层中等反射的外层、一层反射性较弱的中间区及一个高反射性的核心。在开始局部应用皮质类固醇治疗（醋酸泼尼松龙，每滴0.5毫克，每日4次）3天内，肿物增大并导致类血浆房水及前房积脓。组织病理学研究显示为结膜包涵囊肿，伴有急慢性炎症证据。我们发现超声评估有助于虹膜内上皮包涵囊肿的诊断。该病例还提示在局部应用皮质类固醇治疗前切除这些肿物可能更为可取。
