Glaucoma due to ciliary body cysts and pseudoplateau iris: a systematic review of the literature

Abstract

The diagnosis of angle-closure glaucoma secondary to iridociliary cysts is challenging and lacks compiled literature support. We present a rare case of bilateral angle-closure glaucoma associated with pseudoplateau iris due to multiple ciliary cysts and conducted a systematic review of the literature to find similar case reports published between November 2006 and November 2016. Only 19 case reports present treatment modalities, and most cases required more than one therapeutic approach for controlling the intraocular pressure. Pseudoplateau iris attributed to iridociliary cysts should be considered in the differential diagnosis of patients with narrow angles, particularly those with ocular hypertension and glaucoma, in which management is complex. In addition to gonioscopy, ultrasound biomicroscopy is considered the conclusive method for accurate diagnosis.

Multiple iridociliary cysts: One entity with various clinical presentations

“…Ultrasound Biomicroscopy (UBM) is an invaluable imaging tool, which provides a resolution of 20–50 μm and a penetrating tissue depth of 4mm. 1 , 4 , 11 These features allow a better visualization and evaluation of the size, structure, location as well as the extent of involvement of the cysts. 1 , 4 , 11 Therefore, UBM can be used to diagnose iridociliary cysts mimicking iris plateau configuration.…”

“… 1 , 4 , 11 These features allow a better visualization and evaluation of the size, structure, location as well as the extent of involvement of the cysts. 1 , 4 , 11 Therefore, UBM can be used to diagnose iridociliary cysts mimicking iris plateau configuration. This condition is known as pseudoplateau iris and is clinically difficult to distinguish.…”

“…This condition is known as pseudoplateau iris and is clinically difficult to distinguish. 1 , 11 Moreover, UBM may be the only effective tool in differentiating iris cysts from pathologic uveal neoplasms. 11 …”

Iris Pigment Epithelium Cyst Accompanied by Ocular Hypertension

“…İridoplasti ile açının düzeldiği ve uzun dönemde göz içi basıncının kontrol edildiği olgular bildirilmiştir. 9,10…”

Iris cyst and atypical complications

“…For secondary cysts, these complications are more prevalent. (2)(3)(4)(5)(6)(7)(8)(9) Treatment varies from watchful waiting to more invasive procedures, when eye damage occurs. Most authors agreed that simpler, less invasive procedures, such as fine needle aspiration with or without alcohol, or antimitotic agent infusion into the cyst, cryotherapy, diathermal coagulation and laser (thermal or YAG) are probably warranted.…”