Bilateral diffuse uveal melanocytic proliferation associated with the recurrence of a Bartholin gland carcinoma

A 55-year-old woman presented in our department with progressive loss of vision for 3 months and severe neovascular glaucoma. Five years ago, owing to typical proliferative diabetic retinopathy, she had been treated with panretinal photocoagulation. She had been under observation because of type 2 diabetes mellitus since without abnormalities. Sudden neovascular glaucoma and elevated intraocular pressure required transscleral cyclophotocoagulation and cryocoagulation of the peripheral retina 2 months previously. One year previously, she underwent cataract surgery after rapid but typical cortical and nuclear cataract progression.

On examination, best corrected visual acuity was light perception and intraocular pressure was 35 mm Hg in both eyes. Slit lamp examination showed severe bilateral iris neovascularisation (A4B4C4) and reddish, elevated circumferential stromal iris lesions next to small, pigmented nodules (figure 1). Indirect ophthalmoscopy revealed bilateral inferior exudative retinal detachment; no further details could be identified because of hazy vitreous. Ultrasound B-scan demonstrated bilateral diffuse circular choroidal thickening (figure 2A). The ciliary body comprised an inhomogeneous configuration and cystic lesions extending into the peripheral choroid.