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Klinisch-echographische Diagnostik bei Iristumoren

Clinico-echographic diagnostics of iris tumors

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Zusammenfassung

Hintergrund

Die Differenzierung iridaler Raumforderungen stellt eine regelmäßig wiederkehrende diagnostische Herausforderung dar.

Fragestellung

Es soll ein Überblick über die Epidemiologie und das diagnostische Vorgehen bei Iristumoren gegeben werden.

Material und Methoden

Der Beitrag bietet eine Literaturübersicht aus PubMed und eigene klinische Ergebnisse.

Ergebnisse

Die weitaus meisten Iristumoren sind melanozytären Ursprungs, darunter Nävi und Melanome. In der Spaltlampenbiomikroskopie kann eine Größenzunahme im zeitlichen Verlauf dargestellt werden, was der einzig anerkannte klinische Surrogatbefund für ein malignes Geschehen ist. Die Ultraschallbiomikroskopie (UBM) ist zusätzlich obligat, da nur mit ihr Tiefenausdehnung mit etwaiger Ziliarkörperbeteiligung und Binnenstruktur iridaler Tumoren beurteilt werden können.

Schlussfolgerungen

Serielle Spaltlampen- und UBM-Untersuchungen mit reproduzierbarer Pupillenweite sind unverzichtbar in der Differenzierung zystischer, solider und tumorsimulierender Läsionen sowie zur Detektion einer malignen Transformation.

Abstract

Background

The differentiation of iridic space-occupying lesions represents a regularly reoccurring diagnostic challenge.

Objective

This article presents an overview of the epidemiological data and describes the diagnostic procedure for iris tumors.

Material and methods

The article provides a review of the literature from PubMed and own clinical results.

Results

Melanocytic lesions comprise the vast majority of all iris tumors and include nevi and melanomas. Slit lamp biomicroscopy with standardized photography reveals two-dimensional planar tumor growth over time, which is the only recognized clinical surrogate finding for a malignant event. Ultrasound biomicroscopy (UBM) is additionally obligatory because it is the only method which enables documentation of the extent of tumor penetration, ciliary body involvement and internal structure of iris tumors.

Conclusion

Serial slit lamp and UBM examinations with reproducible pupillary diameters are indispensable for the differentiation of cystic, solid and tumor-simulating lesions and for the detection of malignant transformation in iris tumors.

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Authors and Affiliations

  1. Zentrum für Augenheilkunde, Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland

    K. R. Koch, J. M. Mor, G. Avgitidou, A. C. Rokohl & L. M. Heindl

  2. Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland

    V. Kakkassery

Authors
  1. K. R. Koch
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  2. J. M. Mor
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  3. G. Avgitidou
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  4. V. Kakkassery
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  5. A. C. Rokohl
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  6. L. M. Heindl
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Corresponding author

Correspondence to K. R. Koch.

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Interessenkonflikt

K.R. Koch, J.M. Mor, G. Avgitidou, V. Kakkassery, A.C. Rokohl und L.M. Heindl geben an, dass kein Interessenkonflikt besteht. Es wird versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskriptes zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

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Koch, K.R., Mor, J.M., Avgitidou, G. et al. Klinisch-echographische Diagnostik bei Iristumoren. Ophthalmologe 116, 313–323 (2019). https://doi.org/10.1007/s00347-019-0861-y

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