Burris, CK

Papastefanou, VP

Sagoo, MS

UCL Discovery

Bilateral Enlarging Iris Vascular Tufts Vasilios P. Papastefanou, Christopher K. H. Burris, Mandeep S. SagooOcular Oncology Service, Moorfields Eye Hospital, London, United KingdomA 73-year-old female with an unremarkable ophthalmic history presented with a spontaneous left eye hyphema. Anterior segment examination revealed subtle bilateral iris vascular tufts with late leakage on fluorescein angiogram (not shown). The vascular tufts were judged to have enlarged over two years (Fig 1A), with increasing hyperfluorescence and leakage confirmed by indocyaninegreen angiogram (Fig 1B). There was no hyphema recurrence, and visual acuity and intraocular pressures remained within normal limits.  Iris vascular tufts, or Cobb tufts typically follow a benign course.1 Argon laser treatment is reserved for cases complicated by recurrent hyphema.2-4AC EB D FABCDEFFigure 1. Left EyeA	 BCopyright 2016 American Medical Association. All rights reserved.Iris Vascular TuftsVasilios P. Papastefanou, MD, PhD; Christopher K. H. Burris, MD;Mandeep S. Sagoo, BSc, MB, PhD, MRCOphth, FRCS(Ed)A woman in her 70s with an unremarkable ophthalmic historypresented with a spontaneous left eye hyphema. Anterior segmentexamination revealedsubtlebilateral iris vascular tuftswith late leak-age on fluorescein angiogram (not shown). The vascular tufts werejudged to have enlarged over 2 years (Figure, A), with increasinghyperfluorescence confirmed by indocyanine green angiogram(Figure, B). Therewasnohyphema recurrence, andvisual acuity andintraocularpressuresremainedwithinnormal limits. Irisvascular tufts,or Cobb tufts, typically follow a benign course.1 Argon laser treat-ment is reserved for cases complicated by recurrent hyphema.2-4ARTICLE INFORMATIONAuthor Affiliations:Ocular Oncology, MoorfieldsEye Hospital, London, England.Corresponding Author: Christopher K. H. Burris,MD, University of Wisconsin-Madison, 600Highland Ave, Ste K6/435, Madison, WI 53792(burrischristopher@yahoo.com).Conflict of Interest Disclosures: All authors havecompleted and submitted the ICMJE Form forDisclosure of Potential Conflicts of Interest andnone were reported.REFERENCES1. Cobb B. Vascular tufts at the pupillary margin:a preliminary report on 44 patients. TransOphthalmol Soc U K. 1969;88:211-221.2. Goyal S, Foster PJ, Siriwardena D. Iris vasculartuft causing recurrent hyphema and raised IOP:a new indication for laser photocoagulation,angiographic follow-up, and review of laseroutcomes. J Glaucoma. 2010;19(5):336-338.3. Strauss EC, Aldave AJ, Spencer WH, et al.Management of prominent iris vascular tuftscausing recurrent spontaneous hyphema. Cornea.2005;24(2):224-226.4. Dahlmann AH, BensonMT. Spontaneoushyphema secondary to iris vascular tufts. ArchOphthalmol. 2001;119(11):1728.Slitlamp photographA Indocyanine green angiogramBFigure. Iris vascular tufts. A, Slitlamp photograph of the left eye demonstrating multiple iris tufts spanning 3 quadrants ofthe pupillary margin. B, Indocyanine green angiogram demonstrates tufts at the third, seventh, and ninth clock hours.Clinical Review& EducationOphthalmic Imagesjamaophthalmology.com (Reprinted) JAMAOphthalmology December 2016 Volume 134, Number 12 1/1Downloaded From: http://jamanetwork.com/ by a University College London User  on 12/13/2016REFERNCES1.	Cobb	B.	Vascular	tufts	at	the	pupillary	margin:	a	preliminary	report	on	44	patients.	Trans	Ophthalmol Soc U	K.	1969;88:211-221.	2.	Goyal	S,	Foster	PJ,	Siriwardena D.	Iris	vascular	tuft	causing	recurrent	hyphema and	raised	IOP:	a	new	indication	for	laser	photocoagulation,	angiographic	follow-up,	and	review	of	laser	outcomes.	J	Glaucoma.	2010;19(5):336-338.	3.	Strauss	EC,	Aldave AJ,	Spencer	WH,et al.	Management	of	prominent	iris	vascular	tufts	causing	recurrent	spontaneous	hyphema.	Cornea.	2005;24(2):224-226.	4.	Dahlmann AH,	Benson	MT.	Spontaneous	hyphema secondary	to	iris	vascular	tufts.	Arch	Ophthalmol.	2001;119(11):1728.	

Iris Vascular Tufts

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Iris Vascular Tufts

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