Uric acid crystals presenting as an orbital mass

Topping, Nicola; Cassels-Brown, Andy; Chakrabarty, Aruna; Cronin, Paul; Ross, Stuart A.; Russell, Jean; Tesha, Paul

doi:10.1038/sj.eye.6700334

Cited by 12 publications

(2 citation statements)

References 5 publications

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“…Thirty-six articles were found in the literature documenting ocular urate deposition as seen by histopathology and clinical exam ( Table 1 ). Urate deposits have been reported in nearly all ocular and adnexal structures including the eyelid [ 55 ], medial and lateral canthus [ 56 , 57 ], conjunctiva [ 58 ], sclera [ 59 ], cornea [ 60 ], lens, iris [ 61 ], orbital fossa [ 62 ], and retina [ 63 ]. The eyes may be predisposed to tophi secondary to lower body temperatures and a low pH environment resulting in poor solvent capabilities [ 61 , 64 ].…”

Section: Resultsmentioning

confidence: 99%

Systemic Urate Deposition: An Unrecognized Complication of Gout?

Khanna

Johnson

Marder

et al. 2020

JCM

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Gout, an inflammatory arthritis, affects over nine million people in the US with increasing prevalence. Some medical societies do not recommend treating gout unless it is recurrent. While soft tissue urate deposits (tophi), resultant bone erosions, and joint inflammation are frequently recognized in gout, urate crystal deposits in other sites have been thought to be rare. Recent diagnostic testing, such as dual energy computed tomography (DECT), has led to the recognition that urate deposits are not uncommon in other tissues including the vasculature. To understand the potential risks for untreated gout, we reviewed the literature on extra-articular urate deposition documented by autopsy, histopathology, surgery, and radiology, including the heart, blood vessels, kidney, spine, eye, skin, and gastrointestinal system. These studies extend the significance of gout beyond the rheumatologist and emphasize the need for physicians to follow the American College of Rheumatology guidelines to treat subjects with gout to a goal of achieving serum urate <6 mg/dl. Given the growing body of literature on extraarticular urate deposition, further studies and clinical trials are needed to determine the clinical consequences of systemic urate deposition, including if reducing cardiac and vascular urate deposits may provide a survival benefit for this at-risk population.

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Section: Resultsmentioning

confidence: 99%

Systemic Urate Deposition: An Unrecognized Complication of Gout?

Khanna

Johnson

Marder

et al. 2020

JCM

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“…A single case of an orbital mass consisting of urate crystals has been described . This individual presented with periocular pain and ptosis.…”

Section: Introductionmentioning

confidence: 99%

Review of the ophthalmic manifestations of gout and uric acid crystal deposition

Goldblatt

Casson

2016

Clinical Exper Ophthalmology

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Gout is a clinical disorder that is characterized by the deposition of monosodium urate crystals (MSU) in joints and tendons, usually in the presence of prolonged hyperuricaemia. Following an asymptomatic phase of hyperuricaemia, gout usually presents as acute monoarthritis followed by periods of remission and exacerbation. Conjunctival hyperaemia and subconjunctival haemorrhage exacerbated by purine intake are two of the more common manifestations that may go unrecognized. Other ocular and adnexal structures can be affected by urate crystal deposition and associated inflammation, with potentially vision-threatening consequences; however, ocular manifestations of gout are rare and may have been over-reported in the older literature, but our understanding of the clinic-pathological features of ocular urate deposits remains limited.

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