Large case series describes vascular tumors of the iris

This study describes a series of 45 patients with vascular tumors of the iris, providing examples of racemose hemangioma, cavernous hemangioma, capillary hemangioma, varix and microhemangiomatosis seen at the authors' oncology service and from the literature. The authors also propose the use of a simple classification system for vascular tumors of the iris.

The tumors in this series were diagnosed in 54 eyes as racemose hemangioma (41 eyes: 29 simple and 12 complex), cavernous hemangioma (three eyes: two localized and one systemic), capillary hemangioma (one eye, localized), varix (three eyes, localized) and microhemangiomatosis (six eyes, localized). The hemangiomas occurred in adults at a median age of 55 years, whereas capillary hemangioma occurred in infancy and cavernous hemangioma with systemic involvement in a child. None of the eyes with iris racemose hemangioma showed systemic involvement.

Transient hyphema was the main complication seen among all 54 eyes, found at some point in 30 percent or more of each affected eye except for those with iris capillary or racemose hemangioma. Surgical resection was performed in one eye with cavernous hemangioma and one with varix. The remaining cases were managed with observation.

The authors conclude that each type of iris vascular tumor has characteristic clinical features and ocular complications, mainly transient hyphema. Observation is usually advised. Although most are solitary lesions confined to the iris, some, such as cavernous hemangioma and microhemangiomatosis, can have important systemic associations.