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Diffuse iris melanoma: a report of 25 cases
Hakan Demirci1, Carol L Shields, Jerry A Shields
1Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Ophthalmology
|August 3, 2002
Summary
Diffuse iris melanoma, a rare eye cancer, often causes eye color changes and glaucoma, delaying diagnosis. This condition can invade ocular structures and metastasize in 13% of patients.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Diffuse iris melanoma is a rare, flat-growing variant of iris melanoma.
- It frequently presents as unilateral hyperchromic heterochromia and secondary glaucoma.
Purpose of the Study:
- To review clinical features, management, histopathologic findings, and prognosis of diffuse iris melanoma.
- To highlight the diagnostic challenges and outcomes associated with this rare condition.
Main Methods:
- Retrospective case series of 25 consecutive patients with diffuse iris melanoma.
- Analysis included clinical presentation, intraocular pressure, tumor characteristics, treatment modalities, histopathology, and patient follow-up.
Main Results:
- The average age at diagnosis was 49; 52% presented with unilateral darker eye color, and 56% were initially misdiagnosed with glaucoma.
- All patients had heterochromia iridis; 84% had ectropion iridis. Tumor invasion of the trabecular meshwork and Schlemm's canal was common.
- Eighty-eight percent were treated with enucleation. Liver metastasis occurred in 13% of cases after a mean follow-up of 78 months.
Conclusions:
- Diffuse iris melanoma is a significant ocular condition causing heterochromia and glaucoma, frequently leading to delayed diagnosis.
- Local invasion of ocular structures is prevalent, and distant metastasis occurs in a notable percentage of cases.
- Early recognition and management are crucial for improving outcomes in diffuse iris melanoma.