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OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 173

Duplication of iris stroma: A rare case of anterior segment dysgenesis


Department of Cataract, Glaucoma and Anterior Segment, Centre for Sight, New Delhi, India

Date of Web Publication01-Apr-2021

Correspondence Address:
Dr. Swati Singh
Centre for Sight, B-5/24, Safdarjung Enclave, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2526_20

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How to cite this article:
Singh S. Duplication of iris stroma: A rare case of anterior segment dysgenesis. Indian J Ophthalmol Case Rep 2021;1:173

How to cite this URL:
Singh S. Duplication of iris stroma: A rare case of anterior segment dysgenesis. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Apr 11];1:173. Available from: https://www.ijoreports.in/text.asp?2021/1/2/173/312384



A 30-year-old male with BCVA of 20/20 was diagnosed with an accessory layer of iris stroma in OU [Figure 1]a and [Figure 2]a and a Leucomatous corneal opacity (inferotemporal) in OS with iris strands adherent to underlying endothelium [Figure 2]b and [Figure 2]c. Intraocular pressures were normal and angles open with few pigment patches along Schwalbe's line [Figure 1]c and [Figure 2]c. There was no lenticular involvement and optic discs were healthy. AC depth and Pachymetry were 2.47 mm/564 microns (OD) and 2.24 mm/572 microns (OS). Stromal duplication was more evident on dilation [Figure 1]b and [Figure 2]b. Scheimpflug images [Figure 1]d and ASOCT [Figure 2]d confirmed stromal hyperplasia.
Figure 1: Right eye. (a) Diffuse illumination, (b) Post dilation picture showing two distinct layers in iris stroma, (c) Gonioscopy inferior angle showing open angle and pigment on Schwalbe's line, (d) Scheimpflug image showing accessory iris tissue

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Figure 2: Left eye. (a) Diffuse illumination, (b) Post dilation,iris strands are seen reaching underneath the corneal opacity.(c) Gonioscopy shows iris strands inserting into posterior corneal surface inferotemporally, open angle and pigment on Schwalbe's line. (d) Central and mid-peripheral iris on ASOCT shows two distinct layers in iris

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This unusual case of Anterior Segment Dysgenesis falls under the Iridocorneodysgenesis category with some features of Peters anomaly.[1],[2] There are very few reports of stromal hyperplasia.[3],[4],[5] Such patients need to be closely monitored as they can develop glaucoma later in life.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Idrees F, Vaideanu D, Fraser SG, Sowden JC, Khaw PT. A review of anterior segment dysgeneses. Surv Ophthalmol 2006;51:213-31.  Back to cited text no. 1
    
2.
Hoskins HD Jr, Shaffer RN, Hetherington J. Anatomical classification of the developmental glaucomas. Arch Ophthalmol 1984;102:1331-6.  Back to cited text no. 2
    
3.
Luxenberg MN. Hyperplasia of the anterior layer of the iris stroma. Br J Ophthalmol 1965;49:516-20.  Back to cited text no. 3
    
4.
Bakhoum MF, Alexander JM, Perry HD. A pseudopupil: Anterior iris stroma hyperplasia. Ophthalmology 2017;124:775.  Back to cited text no. 4
    
5.
Espandar L, Allingham RR, Afshari N. Stromal duplication of the iris. JAMA Ophthalmol 2013;131:1442.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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