Rahimy Ehsan, Beardsley Robert, Ferrucci Steven, Ilsen Pauline, Sarraf David
Ophthalmic Surg Lasers Imaging Retina. 2013 Nov 25;44 Online:E20-2. doi: 10.3928/23258160-20131111-02.
A 68-year-old Caucasian man with a remote history of daily colloidal silver ingestion presented for ophthalmic examination in which he was noted to have a distinct slate gray skin discoloration. Funduscopy revealed confluent perimacular drusenoid deposits bilaterally, most of which localized at the level of or anterior to the inner segment ellipsoid band by optical coherence tomography (OCT) imaging. Enhanced depth imaging OCT demonstrated marked choroidal thinning. Fluorescein angiogram displayed a dark or silent choroid. Confirmatory serum silver levels were found to be markedly elevated. This report describes a unique geographic maculopathy with large drusenoid deposits anterior to the ellipsoid layer and severe choroidal thinning in association with ocular argyrosis.
一名68岁的白种男性，有长期每日摄入胶体银的病史，前来进行眼科检查，检查中发现他有明显的石板灰色皮肤变色。眼底镜检查显示双侧黄斑周围有融合性的类玻璃膜疣沉积物，通过光学相干断层扫描（OCT）成像，其中大部分位于内段椭圆体带水平或其前方。增强深度成像OCT显示脉络膜明显变薄。荧光素血管造影显示脉络膜呈暗或无荧光状态。血清银水平的确认检测发现明显升高。本报告描述了一种独特的地图状黄斑病变，其特征为椭圆体层前方有大量类玻璃膜疣沉积物以及严重的脉络膜变薄，并伴有眼部银沉着症。
