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Iridocorneal Endothelial Syndrome Masquerading as Iris Melanoma in 71 Cases.
MedLine Citation:
PMID:  21482858     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To describe the clinical features of iridocorneal endothelial (ICE) syndrome in a group of patients referred because of suspected iris melanoma. METHODS: In a noncomparative case series, we performed medical record review for clinical features of ICE syndrome in 71 patients. RESULTS: At presentation, the median patient age was 54 years. All patients were referred for evaluation of a pigmented iris mass, suspected to be a melanoma. The iris color was blue or green in 51 (72%) and brown in 20 (28%). The mass proved to be a combination of iris stromal atrophy in 41 cases (58%) with exposure or loss of the underlying iris pigment epithelium; ectropion iridis in 24 (34%), imparting a disfigured iris with dark-brown color; iris nodules in 5 (7%); traction elevation with iris distortion from peripheral anterior synechia in 57 (80%); and corectopia in 53 (75%), a feature commonly found with iris melanoma. The mean extent of iris atrophy was 2 clock hours. Ectropion iridis was unidirectional in 10 and multidirectional in 14. Additional features of ICE included corneal endothelial guttata-like changes in 33 (46%), corneal edema in 7 (10%), iris pigment epithelial transillumination defects in 12 (17%), polycoria in 1 (1%), and secondary glaucoma with intraocular pressure higher than 22 mm Hg in 7 (10%). CONCLUSIONS: Iridocorneal endothelial syndrome can simulate iris melanoma. Features more suggestive of ICE syndrome include corneal endothelial guttata-like changes and edema, peripheral anterior synechia, multidirectional ectropion iridis, and iris atrophy.
Authors:
Carol L Shields; Margaret V Shields; Vanessa Viloria; Haley Pearlstein; Emil Anthony T Say; Jerry A Shields
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-11
Journal Detail:
Title:  Archives of ophthalmology     Volume:  -     ISSN:  1538-3601     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7706534     Medline TA:  Arch Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Wills Eye Institute, Thomas Jefferson University (Drs C. L. Shields, Say, and J. A. Shields and Mss Shields, Viloria, and Pearlstein), and College of Arts and Sciences, University of Pennsylvania (Ms Pearlstein), Philadelphia, and Biology Department, Franklin and Marshall College, Lancaster (Ms Shields), Pennsylvania; and College of Science, University of Notre Dame, Notre Dame, Indiana (Ms Viloria).
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