{Reference Type}: Journal Article
{Title}: Iris involvement by lymphoma: a review of 13 cases.
{Author}: Mashayekhi A;Shields CL;Shields JA;
{Journal}: Clin Exp Ophthalmol
{Volume}: 41
{Issue}: 1
{Year}: Jan-Feb 2013
{Factor}: 4.383
{DOI}: 10.1111/j.1442-9071.2012.02811.x
{Abstract}: <B>BACKGROUND: </B>To describe the clinical and histopathological features of lymphomas involving the iris.<BR><B>METHODS: </B>Retrospective, descriptive study.<BR><B>METHODS: </B>Fourteen eyes of 13 patients.<BR><B>METHODS: </B>Review of medical records.<BR><B>METHODS: </B>Clinical and histopathological findings.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.