Association homolatérale d’hydrophtalmie, de névrome plexiforme de la paupière supérieure et d’hémihypertrophie faciale dans la maladie de Recklinghausen

Choroidal ganglioneuromas in Francois variant neurofibromatosis-1: A rare retinoblastoma mimic

Neurofibromtosis-1 (NF-1) is the commonest oculo-neuro-cutaneous syndrome with multiple ocular manifestations. Reporting three children who presented with unilateral glaucoma (buphthalmos), ipsilateral facial hemihypertrophy, and eyelid plexiform neurofibroma: completing the triad of François syndrome, a rare NF1 variant. Two presented with leukocoria and were referred to as retinoblastoma suspects. Histopathology showed ganglioneuroma, a benign choroidal tumor, associated with NF-1, which does not need treatment. Knowledge of this rare condition avoids misdiagnosis of retinoblastoma, prevents aggressive management, and the associated psychological impact.

Congenital glaucoma and neurofibromatosis in a monozygotic twin: case report and review of the literature

We describe a dramatic case of an identical twin presenting at birth with unilateral congenital glaucoma. Because of the suspicion of neurofibromatosis 1 a magnetic resonance image of the neural axis was obtained, which revealed a plexiform neurofibroma with spinal cord impingement. Diagnosis of neurofibromatosis 1 was confirmed by 3 months of age with the emergence of café-au-lait spots. This case was compared with all 19 reports published in the English literature of neurofibromatosis 1 associated with congenital glaucoma. Initial presentation, family history, characteristics ofthe clinical syndrome, and outcome of glaucoma in infants with neurofibromatosis 1 and congenital glaucoma were reviewed. A plexiform neurofibroma of the ipsilateral eyelid was present in eight patients and ipsilateral facial hypertrophy occurred in three patients. Café-au-lait spots appeared between the ages of 5 weeks and 8 years; none of the patients were reported to have café-au-lait spots at birth. Newborns with unilateral congenital glaucoma should raise high suspicion for neurofibromatosis 1 and its associated findings, which might need immediate intervention.

Cosmetic possibilities and problems in eyelid neurofibromas

Neurofibromatosis type 1 (NF1) is an inherited systemic disease with frequent ocular involvement. A typical alteration observed in NF1 is the eyelid plexiform neurofibroma, often associated with facial homolateral hypertrophy. In such cases, surgical cosmetic results are rather unsatisfactory, since plexiform neurofibromas classically show a non-capsulated mass, with a marked tendency to local recurrence. The techniques for a cosmetic attempt are discussed on the basis of a personal series of eyelid reconstructions in NF1. The results can be considered satisfactory in some cases, when the orbital shape is preserved and the eyelid structure has not been excessively altered by the neurofibroma; in all other cases, the cosmetic outcome is inferior to the patient's and parents' expectations. The serious problem of recurrence is however a limitation to cosmetic surgery in eyelid neurofibromas.

Choroidal neurofibromatosis with congenital iris ectropion and buphthalmos: relationship and significance

We report a case of unilateral buphthalmos in neurofibromatosis-1 without the other classical characteristics of the François syndrome (triad of unilateral buphthalmos, homolateral eyelid plexiform neuroma, and homolateral facial hemihypertrophy) and emphasize the difficulties in early diagnosis. The painful buphthalmic right eye was enucleated at the age of 13 months. Histopathology demonstrated diffuse choroidal neurofibromatosis in association with congenital iris ectropion syndrome. Cutaneous manifestations of neurofibromatosis subsequently developed in the patient and stigmata of the disease were later identified in other asymptomatic family members.

Buphthalmos and progressive elephantiasis in neurofibromatosis. A report of three cases

Two cases of buphthalmos and regional gigantism in peripheral neurofibromatosis (Von Recklinghausen disease) are described. The ocular hypertension was detected at birth and thereafter the facial hemihypertrophy, café-au-lait spots and neurofibromas. One case presented a progressive facial elephantiasis without buphthalmos. The evolution in neurofibromatous elephantiasis of these three cases is discussed.