Atlas Entry - Diffuse iris nevus

Iris nevus

Category(ies): Glaucoma, Iris

Contributors: Jesse Vislisel, MD(figure 1); Thomas J.E. Clark, MD (figure 2)

Photographers: Randy Verdick, FOPS (figure 1); Brice Critser, CRA (figure 2)

Iris nevi typically appear as hyperpigmented regions of the iris with minimal disruption of the normal iris architecture. However, they may occasionally be associated with ectropion uveae or sectoral cataract. There are two types of iris nevi, Circumscribed or Diffuse. Circumscribed iris nevi are discrete and often nodular. Diffuse iris nevi, as shown in the first photograph, involve an entire sector or rarely the entire iris. Iris nevi have low risk for malignant transformation. In a large case series, only 8% of iris nevi referred for evaluation at an ocular oncology center transformed into melanoma.

An ABCDEF mnemonic was proposed by Shields to help remember the risk factors for growth:

Age < 40
Blood (hyphema)
Clock hour inferior (4:00 to 9:00)
Diffuse configuration
Ectropion uveae
Feathery tumor margin
[1]

Dilated funduscopic examination showed severe, diffuse optic atrophy OD and bow-tie (band) optic atrophy OS — Figure 1: Iris nevus, diffuse

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References:

Shields CL, Kaliki S, Hutchinson A, Nickerson S, Patel J, Kancherla S, Peshtani A, Nakhoda S, Kocher K, Kolbus E, Jacobs E, Garoon R, Walker B, Rogers B, Shields JA. Iris nevus growth into melanoma: analysis of 1611 consecutive eyes: the ABCDEF guide. Ophthalmology. 2013 Apr;120(4):766-72. doi: 10.1016/j.ophtha.2012.09.042. Epub 2013 Jan 3.

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Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

Ophthalmology and Visual Sciences

Iris nevus

Iris nevus

Category(ies): Glaucoma, Iris

Contributors: Jesse Vislisel, MD(figure 1); Thomas J.E. Clark, MD (figure 2)

Photographers: Randy Verdick, FOPS (figure 1); Brice Critser, CRA (figure 2)

References:

Image Permissions: