Abstract

Volume.117 Number.4

Original article : Case report

A Case of Ring Melanoma Found while Treating Traumatic Glaucoma
Kazuyo Manabe1, Nobuo Jo1, Hiroko Tateno1, Nami Shishido1, Kanji Takahashi1, Kenshiro Iwashita2, Taiki Isei3, Chisato Ohe4, Noriko Sakaida4, Yoshiko Uemura4
1 Department of Ophthalmology, Kansai Medical University
2 Iwashita Eye Clinic
3 Department of Dermatology, Kansai Medical University
4 Department of Pathology, Kansai Medical University, Hirakata Hospital

Background: Ring melanoma, a malignant melanoma which infiltrates over 180° degrees of the ciliary body is very rare in Japan. We report a case of ring melanoma found while treating treatment of traumatic glaucoma with an ultrasound biomicroscope (UBM).
Case: A 44-year old woman presented with high intraocular pressure after blunt trauma in her left eye.
Clinical findings: Best-corrected visual acuity OS was 1.2, and intraocular pressure was 30 mmHg. Gonioscopy showed about 180° of the angle recession. Intraocular pressure was difficult to control in spite of anti-glaucoma drug treatment. Rapid progression of iris elevation and 360° thickening of the ciliary body were detected by UBM. We detected atypical cells with melanine granules in the aqueous fluid and positive findings in PET-CT, leading to a diagnosis of ciliary body malignant melanoma. Consequently we enucleated the left eye. The histopathological diagnosis was ring melanoma.
Conclusion: Ring melanoma is an important element in the differential diagnosis for untreatable secondary glaucoma.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 117: 364-370, 2013.

Key words
Ring melanoma, Ciliary body malignant melanoma, Traumatic glaucoma, Ultrasound biomicroscopy
Reprint requests to
Kazuyo Manabe, M.D. Department of Ophthalmology, Kansai Medical University. 2-3-1 Shin-machi, Hirakata-shi, Osaka-fu 573-1191, Japan