Vascular tumors of the iris in 45 patients: the 2009 Helen Keller Lecture.
OBJECTIVE
To report on a series of vascular tumors of the iris.


METHODS
Noncomparative case series. A retrospective medical record review of all patients with an iris vascular tumor was performed to identify the clinical features and develop a simple classification of these lesions. Included were demographics, clinical features, systemic associations, complications, management, and histopathology.


RESULTS
There were 54 eyes in 45 patients with an iris vascular tumor. These were categorized as racemose hemangioma (41 eyes: 29 simple and 12 complex), cavernous hemangioma (3 eyes: 2 localized and 1 systemic), capillary hemangioma (1 eye, localized), varix (3 eyes, localized), and microhemangiomatosis (6 eyes, localized). The hemangiomas occurred in adults at a median age of 55 years, whereas capillary hemangioma occurred in infancy and cavernous hemangioma with systemic involvement occurred in a child. Of the 41 eyes with iris racemose hemangioma, none showed systemic involvement. Of all 54 eyes, transient hyphema was the main complication, found at some point in 30% or more of each affected eye except for iris capillary and racemose hemangioma. Surgical resection was necessary in 1 cavernous hemangioma and 1 varix. The remainder were managed with observation.


CONCLUSIONS
There are now well-documented examples of iris racemose hemangioma, cavernous hemangioma, capillary hemangioma, varix, and microhemangiomatosis. Transient hyphema is the main complication. Observation is usually advised. Most are solitary lesions confined to the iris and some (cavernous hemangioma and microhemangiomatosis) can have important systemic associations.
Shields
Jerry A
JA
Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. jas.cls@comcast.net
Bianciotto
Carlos
C
Kligman
Brad E
BE
Shields
Carol L
CL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006391:Hemangioma / Q000145:classification / Q000473:pathology*; D018324:Hemangioma, Capillary / Q000145:classification / Q000473:pathology; D006392:Hemangioma, Cavernous / Q000145:classification / Q000473:pathology; D006801:Humans; D007498:Iris / Q000098:blood supply*; D015811:Iris Neoplasms / Q000145:classification / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies