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Bilateral diffuse uveal melanocytic proliferation associated with the recurrence of a Bartholin gland carcinoma
  1. A Brüggemann1,
  2. M von Bülow2,
  3. D Finas3,
  4. N E Bechrakis4,
  5. H Hoerauf5,
  6. M Müller1
  1. 1Department of Ophthalmology, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
  2. 2Department of Ophthalmology, General Hospital Barmbek, Hamburg, Germany
  3. 3Department of Gynecology, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
  4. 4Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
  5. 5University Eye Clinic, Georg-August-Universität Göttingen, Göttingen, Germany
  1. Correspondence to Anne Brüggemann, Department of Ophthalmology, University of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; anne.brueggemann{at}uk-sh.de

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Case

A 55-year-old woman presented in our department with progressive loss of vision for 3 months and severe neovascular glaucoma. Five years ago, owing to typical proliferative diabetic retinopathy, she had been treated with panretinal photocoagulation. She had been under observation because of type 2 diabetes mellitus since without abnormalities. Sudden neovascular glaucoma and elevated intraocular pressure required transscleral cyclophotocoagulation and cryocoagulation of the peripheral retina 2 months previously. One year previously, she underwent cataract surgery after rapid but typical cortical and nuclear cataract progression.

On examination, best corrected visual acuity was light perception and intraocular pressure was 35 mm Hg in both eyes. Slit lamp examination showed severe bilateral iris neovascularisation (A4B4C4) and reddish, elevated circumferential stromal iris lesions next to small, pigmented nodules (figure 1). Indirect ophthalmoscopy revealed bilateral inferior exudative retinal detachment; no further details could be identified because of hazy vitreous. Ultrasound B-scan demonstrated bilateral diffuse circular choroidal thickening (figure 2A). The ciliary body comprised an inhomogeneous configuration and cystic lesions extending into the peripheral choroid.

Figure 1

Slit lamp photograph of OD (A) and OS (B): severe bilateral iris neovascularisation (Embedded Image) with reddish, elevated lesions (▼) and small pigmented nodules (↑) of the iris.

Figure 2

Ultrasound B-Scan of OD revealing diffuse circumferential choroidal thickening (Embedded Image), retinal detachment (Embedded Image) (A). Intraoperative fundus view of OS: total retinal detachment, scattered intraretinal and preretinal haemorrhages and patchy pigmentation (B).

She underwent pars plana vitrectomy with subretinal drainage, silicone oil …

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