Take home message:

Next time you see an undiagnosed patient that has iris lesions suspicious for Lisch nodules, obtain an OCT and look for these hyper-reflectant lesions. Their presence may push you to send the patient for further evaluation and work-up with a neurologist to rule out NF1.

It is important to note that we don’t know how many of these lesions can be found in patients who do not have a diagnosis of NF1. Obtaining this information in the future could be critical in determine if IR imaging could be used as a tool for diagnosing NF1. 

For another intriguing case of NF1,
see Case #51 – Multi-Spectral Imaging (MSI)
of Choroidal Lesions in NF