Multimodal imaging for detection of clinically inapparent diffuse iris juvenile xanthogranuloma

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Dermatology

Background:

• Juvenile xanthogranuloma (JXG) is a rare, benign skin condition that can affect infants and children.
• Ocular involvement in JXG, particularly in the iris, is uncommon and can present diagnostic challenges.

Observation:

• A 6-month-old infant presented with recurrent spontaneous hyphema, suggesting an intraocular abnormality.
• Clinical examination did not reveal a visible iris lesion, necessitating advanced imaging techniques.

Findings:

• Multimodal imaging, including fluorescein angiography, anterior segment optical coherence tomography, and ultrasound biomicroscopy, successfully detected a flat, transparent iris lesion.
• Cytopathology confirmed the diagnosis of juvenile xanthogranuloma.

Implications:

• This case highlights the importance of multimodal imaging in diagnosing atypical ocular manifestations of JXG.
• Early detection and diagnosis of iris JXG are crucial for appropriate management and preventing potential vision complications.