Clinical and in vivo confocal microscopic findings of a patient with ocular ochronosis

Kocabeyoğlu, Sibel; Sevim, Duygu Gülmez; Mocan, Mehmet Cem; İrkeç, Murat

doi:10.1016/j.jcjo.2013.12.005

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…In ocular ochronosis, the pigment is typically localized to the sclera, conjunctiva, and limbus. One author described a 25-year-old patient with annular corneal pigmentation in addition to arthropathic changes and skin pigmentation using in vivo confocal microscopy [ 12 ]. Interestingly, this was not observed in our case.…”

Section: Discussionmentioning

confidence: 99%

Descemet’s membrane folds in ochronosis: a case report

Magalhães

Hwas

2022

J Med Case Reports

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Background We present this report of a new ophthalmic finding in a patient with ochronosis. Case presentation An 85-year-old Caucasian male patient with bilateral dark temporal and nasal pigmentation of conjunctiva and sclera was referred to our hospital owing to low visual acuity. On biomicroscopic examination, bilateral horizontal Descemet’s membrane folds were observed. Corneal tomography revealed irregular and asymmetric “against-the-rule” astigmatism in both eyes. Anterior segment optical coherence tomography demonstrated numerous central Descemet’s without edema or other corneal structure alterations. Conclusion This is the first report of Descemet’s membrane folds in ochronosis. These corneal findings suggest that the accumulation of homogentisic acid in the sclera leads to thickening and stiffness of this region. These alterations could remarkably decrease visual acuity owing to topographic corneal curvature alterations, especially in elderly patients.

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Section: Discussionmentioning

confidence: 99%

Descemet’s membrane folds in ochronosis: a case report

Magalhães

Hwas

2022

J Med Case Reports

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“…Ultrastructurally, most of the pigment granules were extracellular, partly altering the collagen fibers and fibrocytes [ 4 , 13 ]. In a recent study, accumulation of hyperreflective crystalline deposits at the level of Descemet membrane and scattered hyperreflective microdeposits more superficially was shown via IVCM in a case of ocular ochronosis with corneal involvement [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The aim of this study is to report laser IVCM, corneal topography, and anterior segment optic coherence tomography (AS-OCT) findings as well as clinical features of two cases with ocular ochronosis due to alkaptonuria. Corneal involvement was revealed with IVCM in a previous case report recently [ 11 ]. However, to the best of our knowledge, this is the first report on the IVCM appearance of prominent scleroconjunctival involvement in concordance with AS-OCT findings.…”

Section: Introductionmentioning

confidence: 91%

In VivoConfocal Microscopy and Anterior Segment Optic Coherence Tomography Findings in Ocular Ochronosis

Biler

Yılmaz

Palamar

et al. 2015

Case Reports in Ophthalmological Medicine

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Purpose. To report clinical and in vivo confocal microscopy (IVCM) findings of two patients with ocular ochronosis secondary due to alkaptonuria. Materials and Methods. Complete ophthalmologic examinations, including IVCM (HRT II/Rostock Cornea Module, Heidelberg, Germany), anterior segment optical coherence tomography (AS-OCT) (Topcon 3D spectral-domain OCT 2000, Topcon Medical Systems, Paramus, NJ, USA), corneal topography (Pentacam, OCULUS Optikgeräte GmbH, Wetzlar, Germany), and anterior segment photography, were performed. Results. Biomicroscopic examination showed bilateral darkly pigmented lesions of the nasal and temporal conjunctiva and episclera in both patients. In vivo confocal microscopy of the lesions revealed prominent degenerative changes, including vacuoles and fragmentation of collagen fibers in the affected conjunctival lamina propria and episclera. Hyperreflective pigment granules in different shapes were demonstrated in the substantia propria beneath the basement membrane. AS-OCT of Case 1 demonstrated hyporeflective areas. Fundus examination was within normal limits in both patients, except tilted optic discs with peripapillary atrophy in one of the patients. Corneal topography, thickness, and macular OCT were normal bilaterally in both cases. Conclusion. The degenerative and anatomic changes due to ochronotic pigment deposition in alkaptonuria can be demonstrated in detail with IVCM and AS-OCT. Confocal microscopic analysis in ocular ochronosis may serve as a useful adjunct in diagnosis and monitoring of the disease progression.

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Cornea and Sclera

Yanoff¹,

Sassani²

2020

Ocular Pathology

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Clinical and in vivo confocal microscopic findings of a patient with ocular ochronosis

Cited by 4 publications

References 10 publications

Descemet’s membrane folds in ochronosis: a case report

Descemet’s membrane folds in ochronosis: a case report

In VivoConfocal Microscopy and Anterior Segment Optic Coherence Tomography Findings in Ocular Ochronosis

Cornea and Sclera

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