Intraocular Xanthomatous Tumor Presenting as Fulminant Uveitis - Case Report

1. Chieh-Yin Cheng, MD¹
2. Chun-Ju Lin, MD^1,2,3
3. Pi-Yu, Chen, MD⁴
4. Jiunn-Feng Hwang, MD^1,2
5. San-Ni Chen, MD^1,2

¹Department of Ophthalmology, Changhua Christian Hospital, Taiwan
²School of Medicine, Chung Shan Medical University, Taichung, Taiwan
³Department of Optometry, Chung Hwa University of Medical Technology, Taiwan
⁴Department of Pathology, Changhua Christian Hospital

Purpose: To report a case of intraocular xanthomatous tumor with presentation of fulminant uveitis.

Methods: Interventional case report.

Result: A 52-year-old male had progressively blurred vision and dull pain for 5 months. He denied any systemic or autoimmune diseases. His vision was 2/200 OS. Prominent hypopyon and iris posterior synechiae were noticed. Sterile uveitis was highly suspected but endogenous endophthalmitis was also considered. Intravitreal antibiotics injection was performed but in vain. Due to persistent inflammation and ocular hypertension, intravenous pulse therapy with methylprednisolone was given. After anterior chamber cleared up, a ciliary body mass just behind iris was discovered and confirmed by magnetic resonance imaging. Surgical intervention for excisional biopsy was performed. The pathology showed a benign xanthomatous tumor.

Conclusion: In the literature, intraocular xanthomatous tumor complicated with fulminant uveitis has never been reported. The presentation of fulminant uveitis and posterior synechiae should be evaluated cautiously. Intraocular tumor should be keep in mind.