Ocular post-transplant lymphoproliferative disorder

We report a case of an iris tumor with muttonfat keratic precipitates in a young patient after liver transplantation surgery. A 6yearold girl underwent liver transplantation for congenital biliary atresia and was subsequently immunosuppressed with oral cyclosporine. We examined her 5 years after transplantation because of a “white nodule in her left eye,” which had been detected by her father one day before visiting our clinic. Ophthalmological examinations revealed symmetric visual acuity and normal afferent papillary reflex. Slitlamp examination revealed a depigmented iris nodule approximately3 × 2 mm with muttonfat keratic precipitates in the anterior chamber. Fundus examination was unremarkable, and computed tomography (CT) of the head, neck, and abdomen showed normal findings. Based on the suspicion of post-transplant lymphoproliferative disorder (PTLD), therapy was initiated, which included tapering cyclosporine and topical mydriatics. After 2.5 months, the lesion resolved and no more muttonfat keratic precipitates were identified in the anterior chamber. In this PTLD case, the patient presented with an iris nodule and muttonfat keratic precipitates, and the ocular PTLD presentation resolved spontaneously after tapering cyclosporine.