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1023.e2 Uveal Cysts

Uveal Cysts
VetBooks.ir Etiology and Pathophysiology

BASIC INFORMATION
• Most are spontaneous in nature but may be TREATMENT
Definition associated with previous trauma or anterior Treatment Overview
Generally benign/incidental, round to ovoid, uveitis. A true cyst is a benign structure that is usually
pigmented intraocular structures arising from • Generally arise from the pigmented epithelial an incidental finding. Removal can be con-
the iris or ciliary body, uveal cysts may be layer of iris or ciliary body templated if the cysts are very large, obstruct
seen attached at the pupillary margin and/ the pupillary axis, cause corneal edema, or are
or posterior iris, free floating in the anterior DIAGNOSIS associated with iris plateauing and glaucoma.
chamber, and rarely in the vitreous.
Diagnostic Overview Acute General Treatment
Synonyms An intraocular mass (noted by the owner or • Usually none required
Anterior chamber cysts, ciliary cysts, iridociliary encountered incidentally on physical exam) • Laser ablation of cysts with Nd:YAG or diode
cysts, iris cysts, pupillary cysts raises the possibility of a uveal cyst. Definitive laser
confirmation is possible in most cases with • Aspiration of the cyst with a 25- to 27-gauge
Epidemiology simple transillumination or ocular ultrasound needle by limbal paracentesis
SPECIES, AGE, SEX evaluation.
Dogs, cats; mean age of dogs is 6.8-9.1 Chronic Treatment
years. Differential Diagnosis Usually not necessary unless chronic uveitis or
• Iridal or anterior uveal melanomas glaucoma is present
GENETICS, BREED PREDISPOSITION • To differentiate uveal cysts (often trans-
Dogs: golden retrievers, Labrador retrievers, lucent and can be transilluminated) from Possible Complications
Boston terriers, Great Danes, rottweilers, neoplastic tissue (more dense/opaque and • Cyst rupture, with adhesion to the corneal
American bulldogs cannot be transilluminated), a strong light endothelium or anterior lens capsule
source such as a Finoff transilluminator is • Mechanical interference with iris function
RISK FACTORS advised. • Aqueous outflow obstruction: secondary
• Breed predisposition glaucoma
• Cysts have been associated with trauma and Initial Database
uveitis Full ocular exam (p. 1137) is performed with Recommended Monitoring
and without mydriasis (topical tropicamide 1%) • For most cases diagnosed incidentally,
ASSOCIATED DISORDERS and with intraocular pressures. monitor q 6-12 months.
Dogs: pigmentary and cystic glaucoma (i.e., • If the condition is associated with uveitis or
glaucoma results as a complication of the cysts) Advanced or Confirmatory Testing glaucoma, recheck q 2-4 months or sooner.
associated with iridociliary cysts in some affected • Ocular ultrasonography may confirm the
golden retrievers, Great Danes, and American diagnosis by revealing a cyst’s anechoic PROGNOSIS & OUTCOME
bulldogs (fluid-filled) center.
• Biopsy of cyst and its contents can be Generally a benign condition, it is of concern
Clinical Presentation performed, but this is rarely indicated. in the golden retriever and Great Dane breeds.
DISEASE FORMS/SUBTYPES
• Free-floating cysts within the anterior
chamber
• Cysts attached to the pupillary margin
• Iridociliary cysts
• Rarely, cysts in the vitreous
• Pigmentary and cystic glaucoma

HISTORY, CHIEF COMPLAINT
• Pigmented intraocular mass 2
• Signs of uveitis (p. 1023) and glaucoma
(p. 387) in predisposed breeds
• Intraocular bleeding (rare) 1
• Vision impairment (rare)
PHYSICAL EXAM FINDINGS
• Single or multiple pigmented masses in
anterior chamber, along pupillary margin,
posterior to the iris, or rarely in the vitreous
• Canine uveal cysts are often translucent such
that they can be transilluminated (i.e., can
see through the cyst[s] using a strong light
source, such as a Finoff transilluminator),
whereas feline uveal cysts may be very dark
and difficult to transilluminate. UVEAL CYSTS Dog with multiple uveal cysts in the anterior chamber (1) and posterior to the iris (2).

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