Bilateral diffuse uveal melanocytic proliferation associated with the recurrence of a Bartholin gland carcinoma

A Brüggemann; M von Bülow; D Finas; N E Bechrakis; H Hoerauf; M Müller

doi:10.1136/bjo.2009.165068

Article Text

Education

Bilateral diffuse uveal melanocytic proliferation associated with the recurrence of a Bartholin gland carcinoma

A Brüggemann1,
M von Bülow2,
D Finas3,
N E Bechrakis4,
H Hoerauf5,
M Müller1

¹Department of Ophthalmology, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
²Department of Ophthalmology, General Hospital Barmbek, Hamburg, Germany
³Department of Gynecology, University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
⁴Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria
⁵University Eye Clinic, Georg-August-Universität Göttingen, Göttingen, Germany

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

https://doi.org/10.1136/bjo.2009.165068

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

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 () with reddish, elevated lesions (▼) and small pigmented nodules (↑) of the iris.

Figure 2

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