Long-term Follow-up of 14 Eyes with Bilateral and Multiple Ciliary Body Cysts: Prognosis of this Rare Entity.

PURPOSE To describe the long-term outcomes of eyes with bilateral and multiple ciliary body cysts (CBC). METHODS This retrospective study included patients with multiple and bilateral CBC diagnosed by High-Resolution Ultrasound Biomicroscopy (UBM) and followed by a single glaucoma specialist from 2000 to 2020. All patients underwent complete ophthalmic examination including dynamic indentation gonioscopy, retinal nerve fiber layer (RNFL) measurement by optic coherence tomography (OCT) and automated perimetry. RESULTS Seven patients (14 eyes) with bilateral and multiple CBC were included with a mean follow-up of 98±39 months. Four eyes of two patients had complete angle closure at first examination and three of them underwent trabeculectomy with good visual outcomes. Four eyes of two patients had a reversible angle-closure at first examination and underwent a UBM-guided laser peripheral iridotomy (LPI) which reopened the irido-corneal angles. Two of these eyes needed intensification of hypotensive drops during the follow-up. Among the six eyes (3 patients) with open angle at first examination, all had had LPI at last follow-up visit, 5 had normal RNFL and VF and 1 received an additional hypotensive drop because of RNFL progression. CONCLUSION Our long-term cohort of bilateral and multiple CBC demonstrates that this rare entity may have a good prognosis if LPI is performed before extension of peripheral anterior synechiae (PAS). Irreversible angle closure required trabeculectomy in 75% of cases in our cohort with however good visual outcomes.