J Korean Ophthalmol Soc.  2018 May;59(5):491-495. 10.3341/jkos.2018.59.5.491.

A Case of Spontaneous Recovery of an Iris Cyst in a Patient with Peritoneal Tuberculosis

• Yoon YS
• Lee S
• Min JK
• Lee CK

• KMID: 2411460
• DOI: http://doi.org/10.3341/jkos.2018.59.5.491

Abstract

PURPOSE
We report a case of spontaneous recovery of an iris cyst with only tuberculosis medication and conservative eye drops when uveitis and angle closure occurred because of a cyst in a patient with peritoneal tuberculosis.
CASE SUMMARY
A 49-year-old female who was diagnosed with iritis and treated with steroid eye drops visited our clinic because of decreased visual acuity 1 month prior. There were anterior chamber inflammation cells and an iris cyst completely obstructing the anterior chamber at 12 o'clock. At the time, the patient had been diagnosed with peritoneal tuberculosis in the Department of Internal Medicine and Gynecology and had been treated with surgery and medication. The patient had no past history of glaucoma, but when the iris cyst developed, the intraocular pressure increased to 29 mmHg and anterior inflammatory cells were seen in the range of +1 to +2. The primary lesion of tuberculosis improved and the iris cyst disappeared with treatments involving medication for tuberculosis, steroid eye drops, and glaucoma eye drops, without invasive treatments such as alcohol curettage, laser treatment, or cyst resection.
CONCLUSIONS
If an iris cyst is a new lesion of the eye, it is necessary to identify the pattern and cause of the iris cyst first, and if a secondary benign iris cyst is suspected, the primary treatment of the causative disease is necessary rather than prompt invasive treatment.

Keyword

Glaucoma; Iris cyst; Tuberculosis

MeSH Terms

Anterior Chamber
Curettage
Female
Glaucoma
Gynecology
Humans
Inflammation
Internal Medicine
Intraocular Pressure
Iris*
Iritis
Middle Aged
Ophthalmic Solutions
Peritonitis, Tuberculous*
Tuberculosis
Uveitis
Visual Acuity
Ophthalmic Solutions

Figure

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  Figure 1 Histopathology of biopsy (A) and computed tomography image of abdomen and pelvis with enhancement (B). (A) Granulomatous inflammation with caseation necrosis is observed in the biopsy material taken from peritoneum (in the circle) (hematoxylin and eosin [H&E] stain ×100). (B) Multiple irregular abscess-like cavities (in the circle) existed in uterine corpus, which indicate bilateral tuberculosis salpingitis with tuberculosis peritonitis and myositis.

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  Figure 2 First slit lamp photography of the iris cyst. Cystic type of iris mass (circle) was shown at superior portion of anterial chamber and some iris pigmentation was also shown in front of the lens (arrows).

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  Figure 3 One month later pictures. Follow up slit lamp photography (A) and gonioscope photography (B). The iris cyst (in the circle) was slightly decreased compare to the initial finding of the slit lamp examination.

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  Figure 4 Two months later pictures. Slit lamp photography (A) and gonioscope photography (B). The iris cyst (in the circle) was almost disappeared and pigmented lesion was remained by slit lamp examination (A) and gonioscopic examination (B).

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