Hipertensión ocular como principal forma de presentación del melanoma uveal
- C Bianciotto
- MA Saornil
- Y Muiños
- MC Méndez
- G Blanco
- JM Frutos-Baraja
- F López-Lara
- R Esteban
ISSN: 0365-6691
Year of publication: 2005
Volume: 80
Issue: 1
Pages: 27-33
Type: Article
More publications in: Archivos de la Sociedad Española de Oftalmologia
Abstract
Purpose: To present a series of patients with uveal melanoma masquerading as ocular hypertension. Methods: Patients diagnosed with uveal melanoma were reviewed, selecting those cases with initial presentation as secondary unilateral glaucoma. Clinical and hystopathological information useful for prognosis was examined, such as anterior border localization, size and shape of the tumor, associated ocular pathology, cell type and degree of extraocular extension. Results: Seven patients out of a total of 160 diagnosed with melanoma presented with ocular hypertension (4.3% of the total). Six tumors were large, with only one of them being middle-size. All cases had an associated asymmetric cataract on the affected side. Four cases had neovascular glaucoma, two pseudo-phacolytic glaucoma and the remaining case had invasion of the anterior chamber angle. All cases were unresponsive to medical treatment for glaucoma, due to the unsuspected tumor they harbored. Visual acuity was lower than 0.1 in the affected eye in all patients. Only one case had extraocular extension. A hystopathologic examination performed in six cases showed that 3 tumors had epithelioid cellularity and also 3 had varying degrees of extrascleral extension. Conclusions: In patients presenting with the association of unilateral glaucoma and asymmetric cataract, it is crucial to perform imaging studies, such as ultrasound, in order to rule out the presence of an intraocular tumor, and to achieve an early diagnosis, improving the patients prognosis and the morbidity of treatments.
Bibliographic References
- Singh, AD, Shields, CL, Shields, JA. (2001). Prognostic factors in uveal melanoma. Melanoma Res. 11. 255-263
- Eskelin, S, Kivela, T. (2002). Mode of presentation and time to treatment of uveal melanoma in Finland. Br J Ophthalmol. 86. 333-338
- McLean, IW, Foster, WD, Zimmerman, LE, Martin, DG. (1980). Inferred natural history of uveal melanoma. Invest Ophthalmol Vis Sci. 19. 760-770
- Lopez, R, Saornil, MA, Blanco, G, Esteban, R, Aguirre, C, Gonzalez, C. (1997). Melanoma uveal enmascarado como ojo ciego y doloroso. Arch Soc Esp Oftalmol. 72. 759-762
- Shields, J, Zimmerman, L. (1973). Lesions simulating malignant melanoma of the posterior uvea. Arch Ophthalmol. 89. 466-471
- Zimmerman, LE. (1973). Problems in the diagnosis of malignant melanomas of the choroid and ciliary body: The 1972 Arthur J. Bedell Lecture. Am J Ophthalmol. 75. 917-929
- (1990). Accuracy of diagnosis of choroidal melanomas in the Collaborative Ocular Melanoma Study: COMS report no 1.. Arch Ophthalmol. 108. 1268-1273
- Bove, R, Char, DH. (2004). Nondiagnosed uveal melanomas. Ophthalmology. 111. 554-557
- Shields, CL, Shields, JA, Shields, MB, Augsburger, JJ. (1987). Prevalence and mechanisms of secondary intraocular pressure elevation in eyes with intraocular tumors. Ophthalmology. 94. 839-846
- Yanoff, M, Scheie, HG. (1970). Melanomalytic glaucoma: Report of a case. Arch Ophthalmol. 84. 471-473
- Van Buskirk, EM, Leure Du Pree, AE. (1978). Pathophysiology and electron microscopy of melanomalytic glaucoma. Am J Ophthalmol. 85. 160-166
- Yanoff, M. (1970). Glaucoma mechanisms in ocular malignant melanomas. Am J Ophthalmol. 70. 898-904
- Escalona-Benz, E, Benz, MS, Briggs, JW, Budenz, DL, Parrish, RK, Murray, TG. (2003). Uveal melanoma presenting as acute angle-closure glaucoma: report of two cases. Am J Ophthalmol. 136. 756-758
- De Gottrau, P, Holbach, LM, Naumann, GO. (1993). Acute glaucoma: first manifestation of malignant melanoma of the choroid. J Fr Ophtalmol. 16. 275-277
- Schwartz, GP, Schwartz, LW. (2002). Acute angle closure glaucoma secondary to a choroidal melanoma. CLAO J. 28. 77-79
- al-Torbak, A, Karcioglu, ZA, Abboud, E, Netland, PA. (1998). Phacomorphic glaucoma associated with choroidal melanoma. Ophthalmic Surg Lasers. 29. 510-513
- Damato, B. (2001). Detection of uveal melanoma by optometrists in the United Kingdom. Ophthalmic Physiol Opt. 21. 268-271
- Litricin, O. (1973). Unsuspected uveal melanomas. Am J Ophthalmol. 76. 734-738
- Escalona-Benz, E, Benz, MS, Briggs, JW, Budenz, DL, Parrish, RK, Murray, TG. (2003). Uveal melanoma presenting as acute angle-closure glaucoma: report of two cases. Am J Ophthalmol. 136. 756-758