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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Published inSaudi journal of ophthalmology Vol. 33; no. 1; pp. 81 - 83
Main Authors Williams, Basil K., Welch, R. Joel, Nwanyanwu, Kristen H., Shields, Carol L.
Format Journal Article
LanguageEnglish
Published Saudi Arabia Elsevier B.V 01.01.2019
Elsevier
Subjects
Case Report
Ciliary body
Hemorrhagic occlusive retinal vasculitis
Intracameral vancomycin
Malignant melanoma
Plaque radiotherapy
Uvea
Intracameral vancomycin
Ciliary body
Plaque radiotherapy
Uvea
Hemorrhagic occlusive retinal vasculitis
Malignant melanoma
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Summary: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.
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ISSN:1319-4534
DOI:10.1016/j.sjopt.2018.09.004