Iris Juvenile Xanthogranuloma Presenting with Hypopyon

Ocul Immunol Inflamm. 2021 Jul 6;1-3. doi: 10.1080/09273948.2021.1936077. Online ahead of print.

Abstract

Purpose: To report a case an iris juvenile xanthogranuloma presenting with hypopyon. Case report: A 45-day-old infant was referred to our clinic for unilateral hypopyon. Slit-lamp examination revealed a 2 mm hypopyon in the left eye while visible areas of the iris were normal. Fundus examination was normal. Topical corticosteroids and antibiotics were initiated. The hypopyon regressed to 0.5 mm after 2 weeks of treatment. The now visible peripheral iris revealed an inferotemporal yellow-brown iris mass. Clinical findings were consistent with juvenile xanthogranuloma of the iris. The patient was referred to the pediatrics department which revealed no systemic involvement. Two months after total regression of hypopyon, the baby presented with a 3 mm spontaneous hyphema causing 50 mmHg intraocular pressure. The patient was followed with topical corticosteroids and antiglaucomatous drops until the hyphema was resolved. Conclusion: ocular involvement, which is the most common extracutaneous 15 manifestation of juvenile xanthogranuloma, should be considered in the differential diagnosis of hypopyon and/or hyphema in young children.

Keywords: Anterior uveitis; hyphema; hypopyon; iris tumor; juvenile xantogranuloma.