BILATERAL DIFFUSE IRIS NODULAR NEVI - CLINICAL AND HISTOPATHOLOGIC CHARACTERIZATION

Background: Diffuse nodular nevus of the iris is an uncommon condition that presents with multiple verrucous excrescences distributed diffus ely on the iris surface. Methods: The authors describe 30 patients wit h bilateral diffuse iris nodular nevi and report associations with bil ateral congenital cataract, neurofibromatosis, oculodermal melanocytos is, congenital ptosis, morning glory anomaly, Axenfeld anomaly, or Pet ers anomaly. Results: Iris nodules were uniform in size and distributi on and were brown, as was the surrounding iris, Light and electron mic roscopy of iridectomy specimens from one patient showed elevated plaqu es composed of aggregates of plump, lightly pigmented nevoid cells int erwoven with mature, densely pigmented spindle-shaped uveal melanocyte s. Conclusions: The authors report the largest clinical series and fir st ultrastructural description of bilateral diffuse iris nodular nevi, which represents a variant of neural crest development. No ocular com plications could be attributed to the iris nodules, which should be di fferentiated from Lisch nodules and other pathologic iris lesions.