Epithelial inclusion cyst of the iris
P. T. Finger, S. A. McCormick, J. Lombardo, C. Tello and R. Ritch
Department of Ophthalmology, New York (NY) Eye and Ear Infirmary, USA.
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.
