Table of Contents - WOC 2012

WOC2012 Abstract Book
Oncology
PO-ONC-01
Iridocorneal Endothelial (ICE) Syndrome masquerading as Iris
Melanoma in 71 cases
Shields Carol L. (1) , Shields Margaret V. (1) , Say Emil Anthony T. (1) , Shields
Jerry A. (1)
1. Wills Eye Institute
Purpose: To describe the features of iridocorneal endothelial (ICE) syndrome
in group of patients referred because of suspected iris melanoma.
Methods: Chart review of 71 patients
Results: The median patient age was 54 years. All were referred for evaluation
of possible iris melanoma. The mass proved to be a combination of iris stromal
atrophy in 41 cases (58%) with exposure or loss of underlying iris pigment
epithelium, ectropion iridis in 24 (34%) imparting a disfigured iris with dark
brown color, iris nodules in 5 (7%), traction elevation with iris distortion from
peripheral anterior synechia in 57 (80%), and corectopia in 53 (75%), a feature
commonly found with iris melanoma. The extent of iris atrophy was mean 2
clock hours. Ectropion iridis was unidirectional in 10 and multidirectional in
14. No case demonstrated polycoria. Additional features of ICE included
corneal endothelial guttata in 33 (46%), corneal edema in 7 (10%), iris pigment
epithelial transillumination defects in 12 (17%), and secondary glaucoma with
intraocular pressure above 22 mm Hg in 7 (10%).
Conclusions: ICE syndrome can simulate iris melanoma. Features more
suggestive of ICE syndrome include corneal endothelial guttata and edema,
peripheral anterior synechia, multidirectional ectropion iridis, and iris atrophy.
PO-ONC-02
Epibulbar Osseous Choristoma in 8 Patients
Shields Carol L. (1) , Qureshi Anam (1) , Eagle, Jr. Ralph C. (1) , Lally Sara E. (1) ,
Shields Jerry A. (1)
1. Wills Eye Institute
Purpose: To describe clinical features of epibulbar osseous choristoma
Methods: Chart review
Results: At diagnosis, the median patient age was 19 years, 6 were female,
and 6 were Caucasian, 1 Hispanic, and 1 African-American. There were no
syndromes. The choristoma was superotemporal (n=8), located in the fornix
(n=4) or equatorial bulbar conjunctiva (n=4), deep to Tenon›s fascia (n=8), and of
yellow (n=2), white (n=2), or pink (n=4) color. The median basal dimension was
median 10 mm and thickness was 4 mm. Management included observation
(n=4) or surgical excision (n=4). There was no growth or recurrence.
Conclusions: Episcleral osseous choristoma is an isolated tumor of mature
bone located superotemporally near the fornix in young patients.
PO-ONC-03
Cytogenetic Testing of Iris Melanoma using Fine Needle Aspiration
Biopsy in 17 cases
Shields Carol (1) , Ramasubramanian Aparna (1) , Ganguly Arupa (1) , Mohan
Diwakar (1) , Shields Jerry A. (1)
1. Wills Eye Institute
Purpose: To determine chromosome 3 monosomy in iris melanoma
Methods: FNAB for genetic analysis (DNA amplification and microsatellite
assay)
Results: Disomy 3 was found in 5 melanomas, partial monosomy 3 in 7, and
complete monosomy 3 in 5. The only feature associated with partial/complete
monosomy 3 was older median patient age (p=0.03). Monosomy 3 melanomas
were thinner (diffuse melanoma) and with greater iris/angle seeding producing
elevated intraocular pressure. Monosomy 3 tumors showed mixed/epithelioid
cell type in 80% vs. 0% in disomy 3 (p=0.14). No patients developed local
metastasis over 16-month mean follow up.
Conclusions: Using FNAB, iris melanoma demonstrated partial or complete
monosomy 3 in 71%, correlating with increasing patient age.
568
PO-ONC-04
Ophthalmoscopic differentiation of Coats› Disease from
Retinoblastoma
Shields Jerry (1) , Shields Carol (1)
1. Wills Eye Institute
Background/Purpose: Coats disease (CD) is often confused clinically with
retinoblastoma. It is important for clinical and legal reasons to differentiate
them. This study was to delineate the features that differentiate CD and
retinoblastoma. Approximately 1400 patients with retinoblastoma and 175
with CD had fundus drawings, photography, fluorescein angiography, and
ultrasonography These were reviewed to establish clinical criteria that serve to
differentiate these conditions.
Results: Features that differed in CD and retinoblastoma included nature of
pupillary reflex, color of subretinal fluid, and caliber and distribution of the
retinal blood vessels. The pupillary reflex and color of subretinal material
are generally yellow in CD and white to gray with retinoblastoma. Macular
involvement with CD shows yellow exudation, whereas macular involvement
with retinoblastoma shows a white mass. The retinal blood vessels in CD
disease are irregular in caliber, whereas in retinoblastoma the retinal vessels
are uniformly dilated and more tortuous. The blood vessels in CD remain visible
from the posterior to the peripheral fundus, whereas those retinoblastoma tend
to disappear into the adjacent neoplasm.
Conclusion: Despite their superficial similarities CD and retinoblastoma usually
have different clinical features. Recognition of these differences can avoid
erroneous diagnosis, misdirected therapy and legal repercussions.
PO-ONC-05
Sentinel episcleral vessels and intraocular malignant tumors
Li Juanjuan (1)
1. Department Ophthalmology
Objective: To investigate the relevance of the sentinel vesseland intraocular
malignant tumors?The probability were analyzed for the diagnosis and
differential diagnosis of intraocular malignant tumors.
Methods: To observe the patients diagnosed iris and choroid malignant
melanoma, analyze the scleral surface sentinel vesselfeatures.
Results: The sentinel incidence was 32%in the intraocular malignant tumor
patients, located in the sclera shallow, showing segmental expansion, within
the tumor in the same quadrant.
Conclusion: Sentinel vessels, with tumor growth rate, uneven pigment
distribution can improve the accuracy of diagnosis of intraocular malignant
tumors.