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Evaluation of Kayser-Fleischer ring in Wilson disease by anterior segment optical coherence tomography.
Indian J Ophthalmol 2017; 65(5):354-357IJ

Abstract

PURPOSE

The purpose of the study is to present anterior segment optical coherence tomography (AS-OCT) as an alternative method of evaluating Kayser-Fleischer (KF) ring in Wilson disease (WD) not only by ophthalmologists but also by other clinicians dealing with WD.

MATERIALS AND METHODS

This was a retrospective case series of six WD patients with KF ring. Evaluation of KF ring was done by naked eye examination using torch light, slit lamp biomicroscopy (SL), and AS-OCT. SL examination was done using a narrow slit of the superior cornea. AS-OCT was done using the Optovue RTvue PremierTM device (Fremont, CA, USA).

RESULTS

AS-OCT revealed KF ring as an intense hyperreflective band at the level of Descemet membrane (DM). Color scale of AS-OCT showed KF ring as greenish/greenish yellow/orange yellow/yellowish/red band. Validation of AS-OCT findings was done by second ophthalmologist, medical gastroenterologist, surgical gastroenterologist, and neurophysician. After seeing the first observation, they could identify the AS-OCT features in all pictures with ease.

CONCLUSIONS

This is the first observation of KF ring in WD on AS-OCT. On AS-OCT, KF ring is visualized as intense hyperreflectivity at the level of DM in the peripheral cornea. Further, studies are needed to evaluate the usefulness of AS-OCT in WD management.

Authors+Show Affiliations

Department of Ophthalmology, Krishna Institute of Medical Sciences, Hyderabad, Telangana, India.KIMS Foundation and Research Centre, Hyderabad, Telangana, India.KIMS Foundation and Research Centre, Hyderabad, Telangana, India.Department of Gastroenterology, Krishna Institute of Medical Sciences, Hyderabad, Telangana, India.Department of HPB and Liver Transplant, Krishna Institute of Medical Sciences, Hyderabad, Telangana, India.Department of Neurology, Krishna Institute of Medical Sciences, Hyderabad, Telangana, India.Department of Ophthalmology, Krishna Institute of Medical Sciences, Hyderabad, Telangana, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28573989

Citation

Sridhar, Mittanamalli S., et al. "Evaluation of Kayser-Fleischer Ring in Wilson Disease By Anterior Segment Optical Coherence Tomography." Indian Journal of Ophthalmology, vol. 65, no. 5, 2017, pp. 354-357.
Sridhar MS, Rangaraju A, Anbarasu K, et al. Evaluation of Kayser-Fleischer ring in Wilson disease by anterior segment optical coherence tomography. Indian J Ophthalmol. 2017;65(5):354-357.
Sridhar, M. S., Rangaraju, A., Anbarasu, K., Reddy, S. P., Daga, S., Jayalakshmi, S., & Shaik, B. (2017). Evaluation of Kayser-Fleischer ring in Wilson disease by anterior segment optical coherence tomography. Indian Journal of Ophthalmology, 65(5), pp. 354-357. doi:10.4103/ijo.IJO_400_16.
Sridhar MS, et al. Evaluation of Kayser-Fleischer Ring in Wilson Disease By Anterior Segment Optical Coherence Tomography. Indian J Ophthalmol. 2017;65(5):354-357. PubMed PMID: 28573989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of Kayser-Fleischer ring in Wilson disease by anterior segment optical coherence tomography. AU - Sridhar,Mittanamalli S, AU - Rangaraju,Advithi, AU - Anbarasu,Kavitha, AU - Reddy,Sharat Putta, AU - Daga,Sachin, AU - Jayalakshmi,Sita, AU - Shaik,Bajibhi, PY - 2017/6/3/entrez PY - 2017/6/3/pubmed PY - 2017/9/20/medline SP - 354 EP - 357 JF - Indian journal of ophthalmology JO - Indian J Ophthalmol VL - 65 IS - 5 N2 - PURPOSE: The purpose of the study is to present anterior segment optical coherence tomography (AS-OCT) as an alternative method of evaluating Kayser-Fleischer (KF) ring in Wilson disease (WD) not only by ophthalmologists but also by other clinicians dealing with WD. MATERIALS AND METHODS: This was a retrospective case series of six WD patients with KF ring. Evaluation of KF ring was done by naked eye examination using torch light, slit lamp biomicroscopy (SL), and AS-OCT. SL examination was done using a narrow slit of the superior cornea. AS-OCT was done using the Optovue RTvue PremierTM device (Fremont, CA, USA). RESULTS: AS-OCT revealed KF ring as an intense hyperreflective band at the level of Descemet membrane (DM). Color scale of AS-OCT showed KF ring as greenish/greenish yellow/orange yellow/yellowish/red band. Validation of AS-OCT findings was done by second ophthalmologist, medical gastroenterologist, surgical gastroenterologist, and neurophysician. After seeing the first observation, they could identify the AS-OCT features in all pictures with ease. CONCLUSIONS: This is the first observation of KF ring in WD on AS-OCT. On AS-OCT, KF ring is visualized as intense hyperreflectivity at the level of DM in the peripheral cornea. Further, studies are needed to evaluate the usefulness of AS-OCT in WD management. SN - 1998-3689 UR - https://www.unboundmedicine.com/medline/citation/28573989/Evaluation_of_Kayser_Fleischer_ring_in_Wilson_disease_by_anterior_segment_optical_coherence_tomography_ L2 - http://www.ijo.in/article.asp?issn=0301-4738;year=2017;volume=65;issue=5;spage=354;epage=357;aulast=Sridhar DB - PRIME DP - Unbound Medicine ER -