Iris microhaemangioma presenting with total hyphaema and elevated intraocular pressure

Abstract

Differential diagnosis included Behcet's disease, sarcoidosis, systemic lupus erythematosus, viral retinitis, and Eales disease. He did not have any systemic signs and symptoms such as oral aphtha, genital lesions, and skin lesions. The absence of these systemic symptoms and laboratory results indicative of autoimmune diseases excluded many of the aforementioned diseases, especially Behcet's disease. Viral retinitis will yield more severe exudates than preretinal or vitreous haemorrhage. It is uncommon in Eales disease that anterior uveitis and dense vitritis exist as seen in our case. 4 This patient and his father have HLA-B27, which is possessed only in 0.8% of the Japanese population. 1 His father had a past history of unknown uveitis. It is quite possible that his disease was also related to the haplotype of HLA-B27. Furthermore, HLA-B27 AAU occurs in B27positive members of the patients' families (approximately 10%) more frequently than in B27-positive healthy controls (1-2%). 5 Posterior segment involvement in HLA-B27-associated uveitis occurs somewhere between 4 and 17.4% in Caucasians. 2,6 Benitez del Castillo reported that the blood-aqueous barrier had been broken when HLA-B27-positive acute anterior uveitis was in active stage. 7 However, these cases usually have good responses to corticosteroid or immunosuppressive therapy. HLA-B27-associated uveitis in Japanese have also good visual prognoses. 8 However, there was no report of PVR despite intensive therapy. Our case, thus, verifies the fact that severe and refractory inflammation can happen in HLA-B27associated uveitis that could lead to the development of PVR in a short period.

Don’t it make my blue eyes brown: heterochromia and other abnormalities of the iris

“…232,246 Spontaneous hyphaema, which may be complicated by secondary raised intraocular pressure, is a well-recognised complication of iris vascular tufts. 237,239,[247][248][249][250][251][252][253][254][255][256] Iris microhaemangiomas are thought to be hamartomas arising from the stromal blood vessels. 235 In 1983 Stur and Strasser 227 described a sectorial racemose arterio-venous malformation in a 32-year-old male.…”

Spontaneous hyphaemas requiring a closer look

“…Gonioscopy may reveal blood in the angle, but is otherwise normal. Fundal examination is also often normal,5 though there have been reports of disc hyperaemia and tortuous retinal vessels associated with IM 7. Anterior segment fluorescein angiography is particularly important if treatment is to be considered, in order to localise tufts.…”

Visual Outcome after Bilateral Implantation of Extended Depth of Focus Intraocular Lens in a Patient with Iris Microhemangiomas

“…Although they are generally asymptomatic, the most common presenting complaint consists of sudden decrease in visual acuity due to hyphema [10][11][12]. Several cases of spontaneous hyphema secondary to IMH have been reported in the literature [1,3,4,8,10,11,[13][14][15][16][17][18][19][20][21].…”