Bilateral Iris Metastasis From Pulmonary Adenocarcinoma

Peng Lu, MD; Jingjing Huang, MD, PhD

Figure. Slitlamp photographs revealed diffuse iris metastasis in the right eye that manifested as a well-defined, semitransparent, jellylike lobular nodule, with iris pigment depositing on its surface (inset).

A man in his 60s presented with blurred vision without pain for 1 month. Visual acuity was 20/40 OU, and intraocular pressure was 37 OD and 46 OS. The patient was diagnosed with histopathologi- cally confirmed pulmonary adenocarcinoma with multiple metas- tases including in his brain. On examination, semitransparent, jelly- likeirisneoplasmsofvaryingsizesandshapeswerefoundinmultiple quadrantsofbotheyes(Figure).Theanteriorchamberangleswere openedinbotheyesbygonioscopy.Dilatedfundusexamination,ul-
trasonography, optical coherence tomography, and ultrasonogra- phybiomicroscopyrevealednoneoplasmsintheciliarybodyorcho- roid.Thepatientwastreatedwithgefitinibandtopicalantiglaucoma medications.
Irismetastasisfromsystemiccancerisuncommon,accounting for only 9% of cases of uveal metastasis.1 Bilateral iris involvement is even more rare, occurring in no more than 3% of cases of iris metastasis.2

Author Affiliations: State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Corresponding Author: Jingjing Huang, MD, PhD, State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun
Yat-sen University, 54 Xianlienan Rd, Guangzhou 510060, China ([email protected]).

Conflict of Interest Disclosures: Both authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. The authors reported support from the National Natural Science Foundation of China (81670850) and the Natural Science Foundation of Guangdong Province in China (2015A030313052).
Additional Contributions: We thank the patient for granting permission to publish this information.

1. Shields CL, Shields JA, Gross NE, Schwartz GP, Lally SE. Survey of 520 eyes with uveal metastases. Ophthalmology. 1997;104(8):1265-1276. doi:10.1016
2. Shields CL, Kaliki S, Crabtree GS, et al. Iris metastasis from systemic cancer in 104 patients: the 2014 Jerry A. Shields Lecture. Cornea. 2015;34 (1):42-48. doi:10.1097/ICO.0000000000000285



(Reprinted) JAMA Ophthalmology September 2018 Volume 136, Number 9 1/1

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