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Iris Microhemangiomatosis With Videographically Documented Active Bleeding and Vision Loss

Nina Ni, MD1; Timothy V. Johnson, MD1; Michael S. Koval, MD1; Carol L. Shields, MD2
[+] Author Affiliations
1Emergency Department, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania
2Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2013;131(12):1649-1651. doi:10.1001/jamaophthalmol.2013.6211.
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Extract

Iris microhemangiomatosis is an unusual, benign vascular abnormality that can cause spontaneous and recurrent hyphema with transient vision loss. Active bleeding is rarely documented and usually presumed, based retrospectively on nontraumatic layered hyphema. We report a case of iris microhemangiomatosis with videographically documented active bleeding.

Article InformationCorresponding Author: Carol L. Shields, MD, Oncology Service, Wills Eye Institute, 840 Walnut St, Ste 1440, Philadelphia, PA 19107 (carol.shields@shieldsoncology.com).

Author Contributions: Dr Ni had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Ni, Johnson, Shields.

Acquisition of data: All authors.

Analysis and interpretation of data: Ni, Johnson, Shields.

Drafting of the manuscript: Ni, Shields.

Critical revision of the manuscript for important intellectual content: All authors.

Administrative, technical, or material support: Ni, Johnson, Shields.

Study supervision: Koval, Shields.

Conflict of Interest Disclosures: None reported.

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Figures

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Figure 1.
Slitlamp Photographs of Pupillary Margin Microhemangiomatosis in Both Eyes

A, Pupillary margin microhemangiomatosis in the right eye with active bleeding at the 11-o’clock position. B, Tiny asymptomatic pupillary margin microhemangiomatosis in the left eye. Close-up view of active bleeding in the right eye before (C) and after (D) argon laser photocoagulation.

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Figure 2.
Iris Fluorescein Angiography in Both Eyes

Fluorescein angiography, performed 1 week after photocoagulation, discloses numerous ectatic vascular tufts at the pupillary margin in early (A) and late (B) frames in the right eye and in early (C) and late (D) frames in the left eye.

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