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Celine Faure, Kiyoko Nakashima, Yannick Le Mer, Isabelle Audo, Michel Paques; Confrontation Of Adaptive Optics, Electrophysiological And Angiographic Findings In A Case Of Ocular Siderosis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):838.
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We report multimodal imaging and functional analysis of a case of post-traumatic ocular siderosis.
A 40-year-old man presented with an iron subretinal foreign body (IOFB) embedded into the sclera underneath the retina in the left eye after hammering. One year after the accident, the IOFB was removed by vitrectomy. Follow-up examination included best corrected visual acuity (BCVA), full-field electroretinogramm (ERG) according to the ISCEV standards, autofluorescence (AF), fluorescein (FA) and indocyanine green (ICG) angiographic imaging. Infrared adaptive optics flood imaging (rtx1, Imagine Eyes, Orsay, France) was performed after IOFB removal.
The subject maintained 20/20 VA during follow-up. Full-field ERG showed an atypical response since a major retinal dysfunction was noted at the photoreceptor level from the start. Angiography showed a mild vitritis associated to papilledema that resolved after IOFB removal. Prepapillary new vessels were seen during a few months after the surgery. AO showed disseminated dots that may correspond to iron particles at the retinal surface with a vascular tropism. Six months later, AO showed a decreased amount of particles, which had also changed their distribution.
Iron particles stayed at the inner surface of the retina, explaining why iron intoxication can continue even after IOFB removal. Modification of the pattern of the iron deposit distribution with vascular tropism may be attributed to macrophagic activity.
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