Iris pigment epithelial cysts
These cysts are fairly rare and classified as central (3%), midzonal (21%), peripheral (73%), and dislodged (3%). The majority of iris pigment epithelial cysts are benign and do not require any treatment.
Contributors: Caroline Y. Yu, MD; Ana Rubin Panvini, MD; Nathaniel C. Sears, MD
Photographer: Laura L. Warner, RTR
Posted March 3, 2020
69-year-old female with no significant ocular history referred for a pigmented iris lesion noted incidentally on exam (Fig 1). Multiple well-defined cystic masses with sonolucent intracavitary fluid and of varied sizes located midzonally and peripherally are seen in both eyes on high frequency anterior segment ultrasonography (Figures 2 and 3). The largest lesion was a midzonal fusiform shaped cyst measuring 1.4mm X 5.88mm. Despite the size and number of cysts, no localized angle closure is seen on echography or exam.
Augsburger JJ, Affel LL, Benarosh DA. Ultrasound biomicroscopy of cystic lesions of the iris and ciliary body. Trans Am Ophthalmol Soc. 1996;94:259–274.
Contributor: Matt Ward, MD
August 15, 2012
(higher resolution of this image not available)
The central cysts above were seen in a 62-year-old female with a history of angle closure glaucoma (perhaps due to enlargement of the cysts).
Lois N, Shields CL, Shields JA, Mercado G. Primary cysts of the iris pigment epithelium. Clinical features and natural course in 234 patients. Ophthalmology. 1998 Oct;105(10):1879-85.
Contributor: Thomas J.E. Clark, MD
Photographer: Brice Critser, CRA
December 22, 2015
On slit lamp examination (photos 2-A and 2-B), an elevation of the inferior iris is seen. It appears as the iris is being pushed or bowed forward from a posterior mass. Folds in the iris can be seen.
On gonioscopy examination (photo 2-C), the elevated, dome-shaped mass is apparent. With careful inspection, the pigment epithelial cyst can be seen through the pupil on the posterior surface of the iris. Also note the major arterial circle of the iris to the left of the cyst.
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