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![Page 1: Retinal Imaging Conference Ahmet Ozkok MD University of Louisville School of Medicine Department of Ophthalmology & Visual Sciences 6/5/14.](https://reader030.fdocuments.us/reader030/viewer/2022032600/56649db15503460f94aa0701/html5/thumbnails/1.jpg)
Retinal Imaging
Conference
Ahmet Ozkok MDUniversity of Louisville
School of MedicineDepartment of
Ophthalmology & Visual Sciences6/5/14
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Subjective CC: Decreased vision OD
HPI: 71 year-old female referred to Retina clinic for decreased vision in theright eye. She complains of difficulty driving and floaters of last few yearsduration and getting worse gradually.
POH: CE+IOL OU 2004
PMHx: NIDDM (10 years), artritis, hypothroidism, GERD
Meds: Omeprozole, hydrocodone, metformin, levothyroxine, meloxicam
Allergies: Codeine
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Exam OD
OS
BCVA 20/80 20/30
-2.00 , +1.00 X 180 -0.50
Pupils: 3 → 2 3 → 2
no APDIOP: 11 mm Hg 12
mm Hg EOM: Full OU
CVF: Full OU
Ant Segment: PCIOL OU
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Slit lamp photo
OD OS
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Exam DFE: OD:
ON: C/D= 0.2Blurry view 2/2 AHVessels: atherosclerotic changes
A/V 1/2 Macula: Blurry
OS:ON: C/D=0.1Macula: blurry viewVeins: Atheroscloric changes A/V
1/2
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OD
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ASSESSMENT
71 year old female with epiretinal membrane and asteroid hyalosis
Plan: PPV+ERMp OD
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ASSESSMENT
POW# 3BCVA 20/60+
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Take Home Message
Fa and oct
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Asteroid Hyalosis Characterized by diffuse spherical white
opacities stuck to vitreous Unilateral (75-90% ) Etiology ? Calcium-associated phospholipids Presence is obvious upon ocular exam but
patients are usually asymtomatic May interfere with retina exam (FA, OCT, AF) Rarely cause visual disturbance and needs Sx
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Asteroid HyalosisRisk Factors
Age
AJO 2001;132:70-75
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Asteroid HyalosisRisk Factors (under
debate) Gender (m>f) DM Hypercholesterol
emia HT Hypercalcemia
Hyperphosphatemia
Hyperopia Gout Alcohol
consumption RP
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Cataract SurgeonBe Careful!
IOL calculation Falsely short axial lenght
measurement with automated biometry
Association between asteroid hyalosis and late postoperative dystrophic calcification of silicone lenses.
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1. Ikeda Y, Hisatomi T, Murakami Y, Miyazaki M, Kohno R, Takahashi H, Hata Y, Ishibashi T: Retinitis pigmentosa associated with asteroid hyalosis. Retina 2010, 30(8):1278-1281.
2. Kador PF, Wyman M: Asteroid hyalosis: pathogenesis and prospects for prevention. Eye 2008, 22(10):1278-1285.
3. Fawzi AA, Vo B, Kriwanek R, Ramkumar HL, Cha C, Carts A, Heckenlively JR, Foos RY, Glasgow BJ: Asteroid hyalosis in an autopsy population: The University of California at Los Angeles (UCLA) experience. Archives of ophthalmology 2005, 123(4):486-490.
4. Browning DJ, Fraser CM: Optical coherence tomography to detect macular edema in the presence of asteroid hyalosis. American journal of ophthalmology 2004, 137(5):959-961.
5. Foot L, Werner L, Gills JP, Shoemaker DW, Phillips PS, Mamalis N, Olson RJ, Apple DJ: Surface calcification of silicone plate intraocular lenses in patients with asteroid hyalosis. American journal of ophthalmology 2004, 137(6):979-987.
6. Mitchell P, Wang MY, Wang JJ: Asteroid hyalosis in an older population: the Blue Mountains Eye Study. Ophthalmic epidemiology 2003, 10(5):331-335.
7. Komatsu H, Kamura Y, Ishi K, Kashima Y: Fine structure and morphogenesis of asteroid hyalosis. Medical electron microscopy : official journal of the Clinical Electron Microscopy Society of Japan 2003, 36(2):112-119.
8. Moss SE, Klein R, Klein BE: Asteroid hyalosis in a population: the Beaver Dam eye study. American journal of ophthalmology 2001, 132(1):70-75.
9. Winkler J, Lunsdorf H: Ultrastructure and composition of asteroid bodies. Investigative ophthalmology & visual science 2001, 42(5):902-907.
References
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Thank you