Date post: | 23-Dec-2015 |
Category: |
Documents |
Upload: | sharyl-meryl-ramsey |
View: | 213 times |
Download: | 1 times |
Retinal Imaging
Conference
Ahmet Ozkok MDUniversity of Louisville
School of MedicineDepartment of
Ophthalmology & Visual Sciences6/5/14
Subjective CC: Decreased vision OD
HPI: 71 year-old female referred to Retina clinic for decreased vision in theright eye. She complains of difficulty driving and floaters of last few yearsduration and getting worse gradually.
POH: CE+IOL OU 2004
PMHx: NIDDM (10 years), artritis, hypothroidism, GERD
Meds: Omeprozole, hydrocodone, metformin, levothyroxine, meloxicam
Allergies: Codeine
Exam OD
OS
BCVA 20/80 20/30
-2.00 , +1.00 X 180 -0.50
Pupils: 3 → 2 3 → 2
no APDIOP: 11 mm Hg 12
mm Hg EOM: Full OU
CVF: Full OU
Ant Segment: PCIOL OU
Slit lamp photo
OD OS
Exam DFE: OD:
ON: C/D= 0.2Blurry view 2/2 AHVessels: atherosclerotic changes
A/V 1/2 Macula: Blurry
OS:ON: C/D=0.1Macula: blurry viewVeins: Atheroscloric changes A/V
1/2
OD
ASSESSMENT
71 year old female with epiretinal membrane and asteroid hyalosis
Plan: PPV+ERMp OD
ASSESSMENT
POW# 3BCVA 20/60+
Take Home Message
Fa and oct
Asteroid Hyalosis Characterized by diffuse spherical white
opacities stuck to vitreous Unilateral (75-90% ) Etiology ? Calcium-associated phospholipids Presence is obvious upon ocular exam but
patients are usually asymtomatic May interfere with retina exam (FA, OCT, AF) Rarely cause visual disturbance and needs Sx
Asteroid HyalosisRisk Factors
Age
AJO 2001;132:70-75
Asteroid HyalosisRisk Factors (under
debate) Gender (m>f) DM Hypercholesterol
emia HT Hypercalcemia
Hyperphosphatemia
Hyperopia Gout Alcohol
consumption RP
Cataract SurgeonBe Careful!
IOL calculation Falsely short axial lenght
measurement with automated biometry
Association between asteroid hyalosis and late postoperative dystrophic calcification of silicone lenses.
1. Ikeda Y, Hisatomi T, Murakami Y, Miyazaki M, Kohno R, Takahashi H, Hata Y, Ishibashi T: Retinitis pigmentosa associated with asteroid hyalosis. Retina 2010, 30(8):1278-1281.
2. Kador PF, Wyman M: Asteroid hyalosis: pathogenesis and prospects for prevention. Eye 2008, 22(10):1278-1285.
3. Fawzi AA, Vo B, Kriwanek R, Ramkumar HL, Cha C, Carts A, Heckenlively JR, Foos RY, Glasgow BJ: Asteroid hyalosis in an autopsy population: The University of California at Los Angeles (UCLA) experience. Archives of ophthalmology 2005, 123(4):486-490.
4. Browning DJ, Fraser CM: Optical coherence tomography to detect macular edema in the presence of asteroid hyalosis. American journal of ophthalmology 2004, 137(5):959-961.
5. Foot L, Werner L, Gills JP, Shoemaker DW, Phillips PS, Mamalis N, Olson RJ, Apple DJ: Surface calcification of silicone plate intraocular lenses in patients with asteroid hyalosis. American journal of ophthalmology 2004, 137(6):979-987.
6. Mitchell P, Wang MY, Wang JJ: Asteroid hyalosis in an older population: the Blue Mountains Eye Study. Ophthalmic epidemiology 2003, 10(5):331-335.
7. Komatsu H, Kamura Y, Ishi K, Kashima Y: Fine structure and morphogenesis of asteroid hyalosis. Medical electron microscopy : official journal of the Clinical Electron Microscopy Society of Japan 2003, 36(2):112-119.
8. Moss SE, Klein R, Klein BE: Asteroid hyalosis in a population: the Beaver Dam eye study. American journal of ophthalmology 2001, 132(1):70-75.
9. Winkler J, Lunsdorf H: Ultrastructure and composition of asteroid bodies. Investigative ophthalmology & visual science 2001, 42(5):902-907.
References
Thank you