Loss of Pattern - Iris Atrophy
Specific conditions:
Age related
● Atrophy of both iris stroma and pigment epithelial layer occurs as a natural aging process
● Bilateral, symmetric iris stromal atrophy.
● Normal pupillary contour with increased prominence of the pigment epithelium and the pupillary sphincter- tan rings
Viral Uveitis
● Chronic inflammation can lead to characteristic iris stromal atrophy
● VZV generally produces sector iris atrophy due to a vascular occlusive vasculitis, whereas HSV usually produces patchy iris atrophy
Essential iris atrophy
● ICE syndrome, unilateral
● Primary defect is believed to be a cellular membrane secreted by the abnormal endothelial cells which covers the iris and the drainage angle of the eye- contraction leads to pupillary changes and formation of PAS - angle closure glaucoma ● Displaced or distorted pupil, patchy areas of iris atrophy and holes in iris.
Trauma
Post cataract surgery due to trauma to iris can lead to iris atrophy after many years.
Pigment Dispersion Syndrome
● Pigment granules settle on iris surface
● Posterior bowing of mid peripheral iris
● Classic mid peripheral,radial slit like transillumination defects in iris best seen on retroillumination.
PXF syndrome
● Particulate pigment deposition on sphincter and peripheral iris
● Moth-eaten transillumination defects occur at the sphincter
Post acute congestive glaucoma
● Partial/total absence of pupillary ruff
● Sphincter atrophy
● Whorling of the iris radial pattern
● Sectoral iris atrophy
Fuch’s Uveitis
● Diffuse atrophy of stroma and posterior pigment epithelium of iris.
● Determines the quality of heterochromia iridis.
Albinism
● Tyrosinase-negative: Lack of melanin
● Iris is diaphanous and translucent giving rise to a ‘pink-eyed appearance’
● Tyrosinase-positive: synthesise variable amounts of melanin.
● Iris may be blue or dark-brown, variable translucency
Axenfeld Rieger Syndrome
● Iris strands adherent to the posterior embryotoxon can range from fine threadlike strands to broad bands of iris tissue.
● Stroma - generalized atrophy with corectopia, ectropion uveae
Image from Rajan Eye Care Hospital
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Causes from entokey.com
