Iris atrophy in a man with diabetes and pigment dispersion glaucoma

A 64-year-old White man with European ancestry returned for follow-up, having a history of severe nonproliferative diabetic retinopathy and stable pigment dispersion. Slit-lamp biomicroscopy was notable for 360° transillumination iris defects [Fig. 1a]. Anterior-segment optical coherence tomography revealed a convex iris with diffuse midperipheral atrophic regions [Fig. 1b]. The coexistence of severe diabetes and pigment dispersion syndrome (PDS) can contribute to the loss of structural integrity of the iris.[1-4] Open angle with moderate trabecular meshwork pigmentation, absence of Krukenberg spindle on the corneal endothelium, low myopia, and intraocular pressures consistently under 10 mmHg led to the decision to continue monitoring. The convex iris configuration observed in this case can be attributed to an age-related increase in lens thickness causing a gradual loss of iris concavity leading to a stage called burnt-out PDS.[1,2]Figure 1: (a) Slit-lamp photograph demonstrating 360-degree transillumination defects of the iris of the right eye using retroillumination. (b) Anterior segment optical coherence tomography scan (Cirrus, Carl Zeiss Meditec, Inc., Dublin, California) of the iris of the right eye illustrating a convex anatomy with atrophic regions in the midperipheryPatient consent Consent to publish this case report has been obtained from the patient in writing. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.