Anterior chamber angle invasion of Iridociliary melanoma

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May 25, 2017359 views

A 70-year-old woman was evaluated before enucleation for a large iridociliary melanoma. On gonioscopy (Fig 1A), it was difficult to differentiate pigment occluding the angle (white arrow) versus tumor mass invading the angle (green arrow). By anterior-segment optical coherence tomography (AS-OCT; Fig 1B), the iridocorneal angle was preserved temporally but effaced nasally (inset, dashed box) by a lesion with medium-to-high reflectivity (green arrowheads). Histopathology (Fig 1C) confirmed the presence of tumor cells invading the anterior chamber angle nasally (green arrowheads) and tracking into Schlemm’s canal (semitransparent oval). AS-OCT correlates well with histopathology and may enhance detection of microscopic anterior chamber angle invasion.

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