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Abstract #19699 Published in IGR 9-4
Ring melanoma revealed by spontaneous hyphema
Abi-Ayad N; Grange JD; Watkin E; De Bats M; Fleury J; Kodjikian L; Gambrelle JJournal Français d'Ophtalmologie 2007; 30: 729-732
INTRODUCTION: Ring melanoma is a rare form of uveal melanoma characterized by the circumferential involvement of the ciliary body. Unilateral chronic and refractory glaucoma is a classic circumstance of diagnosis. OBSERVATION: We report a case of ring melanoma revealed by acute intraocular hypertonia secondary to spontaneous hyphema. Iris and iridocorneal angle were diffusely invaded by the tumor. The fundus was masked but B-scan ultrasonography revealed a voluminous ciliochoroidal tumor. The patient had been enucleated. Pathological examination confirmed the diagnosis of ring melanoma. The tumor involved angle structures. The patient died one year later because of metastasis. DISCUSSION: Acute or chronic ocular hypertonia is a classic but rare circumstance of uveal melanoma diagnosis. Many mechanisms exist: neovascular glaucoma, secondary angle closure, involvement of angle structures, and trabecular obstruction by tumor cells or pigment. Acute intraocular hypertonia secondary to hyphema is more exceptional. Our observation highlights that apart from the classic situation of acute angle closure glaucoma, intraocular hypertonia requires meticulous fundus examination, if necessary using B-scan ultrasonography.
Dr. J. Gambrelle, Service d'Ophtalmologie, CHU de Lyon, Hôpital de la Croix Rousse, 93, Grande rue de la Croix-Rousse, F-69317 Lyon Cedex 04, France. Joel.gambrelle@chu-lyon.fr
Classification:
9.4.8 Glaucomas associated with intraocular tumors (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.4.3.5 Other (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.3 Glaucomas associated with disorders of the iris and ciliary body)
