Active iris vascular tufts bleeding successfully treated with argon laser photocoagulation

Sarmad, Ambreen; Alfaqawi, Fadi; Chakrabarti, Monali; Mitra, Arijit; Mushtaq, Bushra

doi:10.5301/ejo.5001021

Cited by 5 publications

(15 citation statements)

References 7 publications

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“…Spontaneous hyphema can be a rare sequela of IVT. The most common presenting complaint is sudden blurring of vision [2,6,8,13,14,[18][19][20][21][22][23][24][25][26][27][28]38]. However, they can also present as eye pain, discomfort, sudden loss/deterioration of vision, or "blood in the eye" [5,12,[29][30][31].…”

Section: Discussionmentioning

confidence: 99%

“…Cobb's tufts usually remain asymptomatic [3,17]. They can rarely cause spontaneous hyphemas, for which the most common presenting complaint is a sudden blurring of vision [2,6,8,13,14,[18][19][20][21][22][23][24][25][26][27][28]. Less common symptoms are eye pain, discomfort, and sudden loss of vision [5,12,[29][30][31].…”

Section: Signs and Symptomsmentioning

confidence: 99%

“…There have been numerous studies documenting the treatment of hyphema caused by IVT with serial argon laser photocoagulation (ALP) [6,8,14,18,20,21,24,27,31,[34][35][36]. Variable laser parameters are shown in literature, in terms of spot size, laser power, duration, and the number of spots targeted (Table 2).…”

Section: Laser Photocoagulationmentioning

confidence: 99%

“…The parameters used were 500 um spot size, 100 mW power, 0.5 seconds, and eight confluent burns [6]. ALP was utilized for a single episode of active bleeding in four studies [21,27,28,36]. Williams et al (2018) recently published a retrospective observational case series reporting a good outcome from the use of ALP in two cases of active bleeding despite medical therapy with topical steroids and atropine [8].…”

Section: Laser Photocoagulationmentioning

confidence: 99%

“…Cobb’s tufts do not produce symptoms unless the patients develop a hyphema [ 17 ]. Most patients with IVT rarely develop bleeding and rarely re-bleed [ 21 , 27 ]. Studies have shown that most hyphemas resolve without requiring intervention, thus they are initially treated with time and bed rest [ 2 , 15 , 26 , 29 , 30 ].…”

Section: Reviewmentioning

confidence: 99%

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Cobb’s Tufts: A Systematic Review

Almafreji¹,

Manton²,

Peck³

2021

Cureus

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Cobb's tufts, also known as iris vascular tufts (IVT) and iris microhemangiomas (IMH), are coils of tightly clustered, minute blood vessels at the iris pupillary border. This study aimed to analyze previous literature and provide an update on Cobb's tufts. A systematic literature review was carried out by interrogating PubMed, Google Scholar, Cochrane, and Embase databases. Full-text English language articles of any year were included in this study. A total of 38 articles fulfilled our inclusion criteria. A total of 115 reported cases of Cobb's tufts were incorporated into our review. The age of the patients ranged between 36 and 86 years. No sex or racial predisposition was noted. Most patients had no history of trauma, surgery, or blood dyscrasia. The majority of cases are asymptomatic and bilateral unless a spontaneous hyphema occurs, which most commonly presents as blurred vision. The etiology of this condition remains uncertain; however, a higher incidence has been shown in systemic conditions such as myotonic dystrophy and diabetes. Fluorescein angiography can be utilized to investigate tufts. Management includes treatment of raised intraocular pressure, observation for single bleeds, laser therapy for recurrent hyphemas, and lastly, iridectomy, which is considered in cases of recurrence following laser treatment.

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