Optical coherence tomography characteristics of the iris in Cogan-Reese syndrome

Purpose: To describe the characteristic optical coherence tomography (007) findings of the iris in Cogan-Reese syndrome. Methods: A 63-year-old woman was referred for consultation due to diffuse pigmentation of the iris and elevated intraocular pressure (IOP) in the left eye. The clinical examination revealed Cogan-Reese syndrome with pedunculated iris outcroppings on the entire iris surface, and no peripheral anterior synechia. The right eye was normal with normal IOP. Results: Imaging the left iris with the CAM-L cornea lens adapter of the Optovue Fourier-domain OCT (RTVue-OC7) showed a folded iris surface, an increased total iris thickness, and an increased distance between the anterior and posterior iris layers, compared to those of the healthy right eye. Conclusions: Traction by the pathological endothelial cell layer that covers the iris surface in Cogan-Reese syndrome causes characteristic OCT signs in the iris. Detection of the folded iris surface, increase of iris thickness, and increase of the distance between the anterior and posterior iris layers with RTVue-OCT anterior segment examination may promote the correct diagnosis and may help the clinician to discriminate Cogan-Reese syndrome from true iris nevi or iris melanoma.