Encapsulated metallic intraocular foreign body of long duration presenting with cystoid macular edema and normal full-field electroretinogram

Dhoble, Pankaja; Velis, Girish; Sivakaumar, Priya

doi:10.4103/ojo.ojo_39_2017

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…Patients who experience open globe injury with a retained IOFB shortly after trauma have been advised to undergo IOFB removal to avoid retinal toxicity. Some patients with undetected retained IOFB may present with visual loss and chronic ocular inflammation, or they may be detected incidentally, as observed in the present patient [2]. IOFBs can be broadly classified as composed of organic and inorganic materials, with the latter including metals, glass, and plastics.…”

Section: Discussionmentioning

confidence: 89%

“…Therefore, the projectile that had penetrated his sclera was likely an inert object or an encapsulated metal as a result of giant cell reaction. A retained encapsulated metallic IOFB can be asymptomatic, as the encapsulation limits the free passage of active metal ions [2]. Moreover, metallic IOFBs are asymptomatic if made of an inert metal, such as silver, aluminum, platinum, or gold [4].…”

Section: Discussionmentioning

confidence: 99%

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A Patient with an Inert Intraocular Foreign Body

Ng¹,

Goh²

2019

Cureus

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A 29-year-old man was brought to the hospital for treatment after an alleged workplace accident. Initial assessment revealed only mild chest injury and mild confusion, with no other injury. His vision was unaffected with no relative afferent pupillary defect. A computed tomography scan of the brain, performed to rule out brain injury, revealed an incidental finding of a foreign body in the left intravitreal cavity with no other significant findings. Further examination of his medical history revealed that he had experienced a trauma one year earlier, in which his left eye was pierced by a projectile. Immediately post-trauma, his vision had been reduced significantly, but improved over the next few weeks without medical treatment. The current examination of his left eye revealed a small hyperpigmented area on the sclera, representing the point of entry of his previous wound. An encapsulated foreign body was observed in the inferior intravitreal cavity, surrounded by retinal atrophy, and a normal posterior pole. He was managed conservatively without complications. The decision to remove a missed retained intraocular foreign body is complex and depends on multiple factors, including surgical difficulty and the composition, size, and location of the retained foreign body. Removal should be weighed against the possible serious complications of intraocular surgery. If removal is surgically difficult, or the retained material is inert, patients can be managed conservatively with regular monitoring.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

A Patient with an Inert Intraocular Foreign Body

Ng¹,

Goh²

2019

Cureus

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“…In particular, iron has an affinity for acid mucopolysaccharides, one of the main components of vascular adventitia that cause toxic microvasculopathy and uncontrolled macrophagic activity. This phenomenon is responsible for the consequent degeneration of internal retinal layers, supplied only by retinal capillaries [ 5 , 29 ]. These alterations add to photoreceptors and RPE changes already present in the early phase.…”

Section: Pathogenesismentioning

confidence: 99%

“…OCT also shows whether an IOFB is embedded or not by a fibrous membrane, helping surgeons in the decision-making process on whether the removal is urgent or not because IOFB encapsulation slows OS development [ 1 , 80 ]. Moreover, OCT detects macular pathologies, such as epiretinal membrane or oedema, which may be hardly identified by fundus examination [ 29 , 80 ] (Fig. 5 ).…”

Section: Imagingmentioning

confidence: 99%

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Ocular siderosis: a misdiagnosed cause of visual loss due to ferrous intraocular foreign bodies—epidemiology, pathogenesis, clinical signs, imaging and available treatment options

et al. 2020

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Purpose The purpose of this paper is to provide a meaningful literature review about the epidemiology, pathogenesis, clinical signs, imaging and treatment of ocular siderosis (OS). Methods A computerized search from inception up to March 2020 of the online electronic database PubMed was performed using the following search strings: “ocular siderosis” and “siderosis bulbi”. The reference list in each article was analysed for additional relevant publications. Results OS is an uncommon cause of visual loss due to a retained ferrous intraocular foreign body (IOFB). It may develop from 18 days to years after a penetrating trauma that usually occurs during hammering. On average, patients are 22–25 years old, and the vast majority are male. The most common cause of OS development is delayed presentation by the patient or missed diagnosis of IOFB after trauma. The pathophysiology is not fully understood; nevertheless, iron deposition causes hydroxyl radical formation, which damages photoreceptors and retinal pigment epithelium. Moreover, iron damages retinal vessels with consequent inner retinal layers degeneration. The most frequent signs are iris heterochromia, pupillary mydriasis, cataract development and retinal arteriolar narrowing with pigmentary retinal degeneration. Electroretinogram signs, in particular, b-wave amplitude reduction, arise earlier than clinical signs. Orbital CT scans and ultrasonography play an essential role in detecting IOFBs. Treatment depends on the IOFB location and OS development. However, it is crucial to remove the IOFB after OS development because visual acuity and clinical signs may improve. Anterior segment IOFBs can be dislodged using an intraocular magnet (IOM) or forceps through limbal paracentesis. In contrast, posterior segment IOFBs require a pars plana vitrectomy and IOM or forceps to be removed through an enlarged sclerotomy or the limbus. Conclusion Recommending the usage of protective glasses and spreading knowledge about OS may further benefit patient care.

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A rare asymtomatic metallic foreign body retained in the subconjunctival space for over 50 years: A Case Report

Su,

Jiang,

et al. 2024

Preprint

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Background Superficial foreign body present on the conjunctiva or cornea can be easily detected and removed, and may pose minimal harm if addressed promptly. In this report, we present a case with a metallic foreign body remained within the subconjunctival space for over 50 years without significant ocular complications.Case presentation: An 80-year-old woman complained of tearing and blurred vision in the left eye. Slit-lamp examination showed the presence of a tiny metallic foreign body within subconjunctival space and the cataract in the left eye. No further abnormal findings were observed in the fundus and extraocular components during the examination. After inquiring about the patient's history of trauma, it was revealed that over 50 years ago, the patient experienced an ocular injury from a shard of iron while working at a factory. Since the patient's strong desire to alleviate ocular discomfort, the subconjunctival foreign body was removed under topical anesthesia in the operating room. After a 1-month follow-up, the patient reported the complete relief of tearing symptoms.Conclusions In this case, there appears to be no severe consequences associated with the long-term retention of a subconjunctival metallic foreign body. Nonetheless, it is imperative to conduct meticulous patient evaluations and interventions to mitigate the potential risk of injury.

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Encapsulated metallic intraocular foreign body of long duration presenting with cystoid macular edema and normal full-field electroretinogram

Cited by 4 publications

References 7 publications

A Patient with an Inert Intraocular Foreign Body

A Patient with an Inert Intraocular Foreign Body

Ocular siderosis: a misdiagnosed cause of visual loss due to ferrous intraocular foreign bodies—epidemiology, pathogenesis, clinical signs, imaging and available treatment options

A rare asymtomatic metallic foreign body retained in the subconjunctival space for over 50 years: A Case Report

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