SALUD Visual

Iris pigmented epithelial (IPE) cysts:
▪️Primary cysts of the IPE are divided into 4 main types: pupillary margin, midzonal, peripheral, and dislodged.
➖Pupillary margin (Central) IPE Cysts:
Pupillary margin (central) IPE cysts can be unilateral and solitary or bilateral and multifocal.
▫️The unilateral (solitary) type is uncommon, congenital, and can be visualized before the pupil is dilated as a brown lesion usually at the pupillary border in any quadrant. It can occasionally rupture spontaneously but does not pose a serious visual problem. Rarely, some cases are associated with iris nevus or iris melanoma.
▫️The bilateral multifocal variant of pupillary margin IPE cysts is characterized by variable-sized dark-brown lesions that can encircle the pupil and overlie the pupillary margin. They often spontaneously collapse and then reform, producing irregular wrinkled lesions known as iris flocculi. Even when extensive, they cause little, if any, visual impairment, and most remain relatively stable throughout the patient’s life.
➖A number of patients with congenital iris flocculi have been found to have an associated aortic artery dissection later in life. This seems to be related to a mutation in smooth muscle that resides in both the iris and the aorta.
Credit: www.journals.lww.com/apjoo/
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