Abstract
This study evaluated the characteristics and clinical course of patients with iris cysts in the long-term follow-up (24–48 months). We retrospectively analyzed the medical records of 39 patients with iris cysts (27 women and 12 men). Age, visual acuity, intraocular pressure (IOP), slit-lamp evaluation, and ultrasound biomicroscopy images were assessed. The mean age at diagnosis was 40.6 ± 17.48 years. Thirty (76.9%) cysts were peripheral, five (12.8%) were located at the pupillary margin, two (5.1%) were midzonal, and two (5.1%) were multichamber cysts extending from the periphery to the pupillary margin. A total of 23 (59%) cysts were in the lower temporal quadrant, 11 (28.2%) were in the lower nasal quadrant, and 5 (12.8%) were in the upper nasal quadrant. Cyst size was positively correlated with patient age (rs = 0.38, p = 0.003) and negatively correlated with visual acuity (rs = −0.42, p = 0.014). Cyst growth was not observed. The only complication was an increase in IOP in three (7.7%) patients with multiple cysts. The anatomical location of the cysts cannot differentiate them from solid tumors. The vast majority of cysts are asymptomatic, do not increase in size, and do not require treatment during long-term follow-up.
Highlights
The elevation of the iris seen on a slit lamp examination is always of concern to the ophthalmologist because of the suspicion of a tumor in the iris or ciliary body
Policies developed by Shields et al [2] are intended to help distinguish benign changes such as iris cysts from melanoma
Secondary cysts may result from implantation of the conjunctival epithelium, cornea, or eyelid skin into the iris, tumor metastasis, parasitic infections, or chronic use of miotics [4]
Summary
The elevation of the iris seen on a slit lamp examination is always of concern to the ophthalmologist because of the suspicion of a tumor in the iris or ciliary body. Policies developed by Shields et al [2] are intended to help distinguish benign changes such as iris cysts from melanoma. Primary cysts, which are epithelial in origin, predominate. They have thin, regular walls and a hypoechoic interior. The cause of the formation of secondary cysts is most often trauma to the penetrating eyeball or surgical intervention. They can take the form of compact masses (“pearls”), reservoirs filled with fluid (serous cysts), or cause intraepithelial growth. They usually have large dimensions (approximately 5 mm in cross-section) and thick walls (approximately 0.4 mm). Their growth is varied; initially they can increase rapidly and remain the same in the later period
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