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December 1979

Iris Neovascular TuftsRelationship to Rubeosis, Insulin, and Hypotony

Arch Ophthalmol. 1979;97(12):2346-2352. doi:10.1001/archopht.1979.01020020562014

• Iris neovascular tufts are abnormal proliferations of twisted microcapillary loops that project from the iris pupillary border. They appear to be a morphologic variant of rubeosis iridis. This study searched for iris neovascular tufts by biomicroscopy and iris fluorescein angiography. They were found in two of 16 (12.5%) myotonic dystrophy patients, in two of 30 (6.7%) maturity-onset diabetics, and in zero of 14 (0%) juvenile-onset diabetics. Myotonics and adult-onset diabetics have in common pancreatic β-cell dysfunction, abnormally high serum insulin levels, and possibly defective hormone-receptor interactions. Whether these factors contribute to the altered blood-iris barrier and iris neovascular tufts in these groups is uncertain, but a correlation is suggested because the myotonic with the highest insulin level also had the most prominent tufts. Hyperinsulinemia and ocular hypotony are associated with neovascular tufts.