%0 Journal Article
%T Iris involvement by lymphoma: a review of 13 cases.
%A Mashayekhi A
%A Shields CL
%A Shields JA
%J Clin Exp Ophthalmol
%V 41
%N 1
%D Jan-Feb 2013
%M 22594613
%F 4.383
%R 10.1111/j.1442-9071.2012.02811.x
%X BACKGROUND: To describe the clinical and histopathological features of lymphomas involving the iris.
METHODS: Retrospective, descriptive study.
METHODS: Fourteen eyes of 13 patients.
METHODS: Review of medical records.
METHODS: Clinical and histopathological findings.
RESULTS: Median patient age was 58 years (range, 25-76 years). Seven patients had known systemic lymphoma of which five were of large B-cell type. Symptoms included blurred vision (8/14), eye redness (3/14) and eye pain (2/14). Four eyes had secondary elevated intraocular pressure. Anterior segment findings included anterior chamber cells (14/14 eyes), keratic precipitates (11/14 eyes), congestion of conjunctival/episcleral blood vessels (9/14), hyphaema (7/14), conjunctival/anterior epibulbar lymphoma (6/14), tumour-induced pseudohypopyon (4/14) and corneal oedema (3/14). Of 12 eyes with adequate view of iris details, clinically detectable iris thickening or visible mass was noted in all (12/12). There was concomitant involvement of ciliary body (8/14), choroid (5/14) and orbit (2/14). All patients had biopsy of conjunctiva, episclera, iris or ciliary body, confirming the diagnosis of lymphoma. Histopathological or cytopathological evaluation of iris or ciliary body showed high-grade lymphoma in 9/11 eyes in which it was performed. Five patients did not have long-term follow up and, of the other eight patients, three died from complications of systemic lymphoma during follow up ranging from 1 to 44 months.
CONCLUSIONS: Lymphomatous involvement of the iris should be considered in the differential diagnosis of corticosteroid-resistant uveitis in middle-aged and elderly patients. Iris lymphoma tends to be high grade and usually develops in patients with known aggressive systemic lymphoma.