Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma
Hemorrhagic occlusive retinal vasculitis (HORV) is a condition associated with intraocular vancomycin during surgical intervention, most frequently following bilateral sequential cataract surgery. Because of the high rate of ophthalmic vascular complications in this condition, gonioscopic evaluation...
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Wolters Kluwer Medknow Publications
2019-01-01
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doaj-b0b34f60880043b49dc8d260819e0f562021-04-02T20:59:47ZengWolters Kluwer Medknow PublicationsSaudi Journal of Ophthalmology1319-45342019-01-013318183Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanomaBasil K. Williams, Jr.0R. Joel Welch1Kristen H. Nwanyanwu2Carol L. Shields3Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USAOcular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USADepartment of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USAOcular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA; Corresponding author at: Ocular Oncology Service, Suite 1440, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, USA. Fax: +1 (215) 928 1140.Hemorrhagic occlusive retinal vasculitis (HORV) is a condition associated with intraocular vancomycin during surgical intervention, most frequently following bilateral sequential cataract surgery. Because of the high rate of ophthalmic vascular complications in this condition, gonioscopic evaluation for identification of neovascularization of the angle and iris is essential. Careful examination can reveal previously asymptomatic and unassociated lesions of the iris or ciliary body. We present the case of a 71-year-old female who was diagnosed with a ciliary body melanoma secondary to complete ophthalmic examination associated with HORV. She reported decreased vision to light perception in the left eye (OS) following sequential, bilateral cataract surgery. Fundus examination OS demonstrated diffuse retinal vasculitis, retinal ischemia, and extensive hemorrhage. Evaluation included inflammatory and coagulopathy laboratory evaluation, carotid ultrasonography and magnetic resonance imaging (MRI) of the brain and orbits, all of which proved unrevealing, except for an enhancing mass OS on MRI. Further evaluation revealed a pigmented mass with features of melanoma in the anterior chamber angle extending into the ciliary body. Fine needle aspiration biopsy revealed high risk cytogenetic characteristics, and plaque radiotherapy was successfully employed. Keywords: Ciliary body, Hemorrhagic occlusive retinal vasculitis, Intracameral vancomycin, Malignant melanoma, Plaque radiotherapy, Uveahttp://www.sciencedirect.com/science/article/pii/S1319453418301474 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Basil K. Williams, Jr. R. Joel Welch Kristen H. Nwanyanwu Carol L. Shields |
spellingShingle |
Basil K. Williams, Jr. R. Joel Welch Kristen H. Nwanyanwu Carol L. Shields Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma Saudi Journal of Ophthalmology |
author_facet |
Basil K. Williams, Jr. R. Joel Welch Kristen H. Nwanyanwu Carol L. Shields |
author_sort |
Basil K. Williams, Jr. |
title |
Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma |
title_short |
Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma |
title_full |
Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma |
title_fullStr |
Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma |
title_full_unstemmed |
Hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma |
title_sort |
hemorrhagic occlusive retinal vasculitis leading to the diagnosis of ciliary body melanoma |
publisher |
Wolters Kluwer Medknow Publications |
series |
Saudi Journal of Ophthalmology |
issn |
1319-4534 |
publishDate |
2019-01-01 |
description |
Hemorrhagic occlusive retinal vasculitis (HORV) is a condition associated with intraocular vancomycin during surgical intervention, most frequently following bilateral sequential cataract surgery. Because of the high rate of ophthalmic vascular complications in this condition, gonioscopic evaluation for identification of neovascularization of the angle and iris is essential. Careful examination can reveal previously asymptomatic and unassociated lesions of the iris or ciliary body. We present the case of a 71-year-old female who was diagnosed with a ciliary body melanoma secondary to complete ophthalmic examination associated with HORV. She reported decreased vision to light perception in the left eye (OS) following sequential, bilateral cataract surgery. Fundus examination OS demonstrated diffuse retinal vasculitis, retinal ischemia, and extensive hemorrhage. Evaluation included inflammatory and coagulopathy laboratory evaluation, carotid ultrasonography and magnetic resonance imaging (MRI) of the brain and orbits, all of which proved unrevealing, except for an enhancing mass OS on MRI. Further evaluation revealed a pigmented mass with features of melanoma in the anterior chamber angle extending into the ciliary body. Fine needle aspiration biopsy revealed high risk cytogenetic characteristics, and plaque radiotherapy was successfully employed. Keywords: Ciliary body, Hemorrhagic occlusive retinal vasculitis, Intracameral vancomycin, Malignant melanoma, Plaque radiotherapy, Uvea |
url |
http://www.sciencedirect.com/science/article/pii/S1319453418301474 |
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