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R. H. Ghafouri, A. Katz, D. Husain; West African Crystalline Maculopathy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2117.
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To describe the clinical findings of West African Crystalline Maculopathy affecting elderly immigrants from West Africa living in the northeast United States in a retrospective and observational case series.
Nine patients evaluated by the retina service at Boston University Medical center over a 5 -year period were identified as having a characteristic crystalline maculopathy. Each individual engaged in detailed questioning and comprehensive ophthalmological evaluation including fundus biomicroscopy, color vision testing, Humphrey visual field analysis, fluorescein angiography and optical coherence tomography.
16 eyes of nine patients (mean age 57.8), seven of which are members of the Igbo tribe of southeast Nigeria, demonstrated a unique crystalline maculopathy characterized as central, superficial clusters of yellow, refractile, foveal crystals. Crystal deposition was bilateral in 7 patients although often asymmetric in distribution. Visual acuity ranged from 20/25 to 20/100. The most common ocular comorbidity was non-proliferative diabetic retinopathy, which was seen in 3 of 9 patients. Fluorescein angiography and optical coherent tomography did not show any significant findings. The crystals did not appear to affect visual acuity and were unassociated with any visual field defect.
As the largest case series of West African Crystalline Maculopathy, these elderly members from West Africa demonstrate a unique form of crystalline maculopathy. Although the exact cause is unknown, it is believed that this maculopathy can be associated with genetic, environmental and toxic causes. In addition, diabetic retinopathy was observed in many of our patients.
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