A Case of Retinitis Pigmentosa With a Decrease in Visual Acuity Secondary to Asteroid Hyalosis

Abstract

Purpose: : To report clinical characteristics and efficacy of vitrectomy in a patient of retinitis pigmentosa with asteroid hyalosis.Background: Asteroid hyalosis is a degenerative condition in which fatty calcium granules appear within the vitreous. The condition rarely causes visual acuity loss, thus surgical removal is rarely required. Asteroid hyalosis has been reported to occur in retinitis pigmentosa, however, clinical relevance of this condition was not fully assessed.

Methods: : case report

Results: : The patient, 58 years-old male with retinitis pigmentosa, visited Kyoto University hospital because he noticed loss of vision in his left eye. He had received a cataract surgery 2 years ago and his left best-corrected visual acuity (BCVA) improved 0.6 to 0.8 (visual acuities were measured using Landolt C targets). He noticed visual impairment of his left eye several weeks after the surgery. He was explained that this was because of progression of the retinal degeneration. At the initial visit to our clinic, his BCVA in left eye was 0.3. There was a thick asteroid hyalosis in his left vitreous fluid and this prevented detailed fundus examination. Goldman perimetry showed marked peripheral visual field loss but central scotoma was not detected. Because of those clinical examinations and the rapid onset of the symptom, we considered that the asteroid hyalosis might affect the vision loss in this case. We performed vitrectomy and removed the asteroid hyalosis. His left BVCA recovered to 0.6 with no significant side effects.

Conclusions: : We experienced a case of successful vitrectomy to asteroid hyalosis with retinitis pigmentosa. Because the visual field is in the patients of retinitis pigmentosa, it may possible that vitreous opacity affect easily to the visual acuity. Indication of vitrectomy to asteroid hyalosis should be carefully considered with regard to VA change and patient’s symptoms.

Keywords: retinitis