Bilateral Iris Metastasis From Pulmonary Adenocarcinoma

Abstract

A man in his 60s presented with blurred vision without pain for 1 month. Visual acuity was 20/40 OU, and intraocular pressure was 37 OD and 46 OS. The patient was diagnosed with histopathologically confirmed pulmonary adenocarcinoma with multiple metastases including in his brain. On examination, semitransparent, jellylike iris neoplasms of varying sizes and shapes were found in multiple quadrants of both eyes (Figure). The anterior chamber angles were opened in both eyes by gonioscopy. Dilated fundus examination, ul-trasonography, optical coherence tomography, and ultrasonography biomicroscopy revealed no neoplasms in the ciliary body or choroid. The patient was treated with gefitinib and topical antiglaucoma medications.Iris metastasis from systemic cancer is uncommon, accounting for only 9% of cases of uveal metastasis. 1 Bilateral iris involvement is even more rare, occurring in no more than 3% of cases of iris metastasis. 2