El Boukhrissi F, Laktaoui A, Hommadi A, Bamou Y, Balouch L
Faculté de médecine et de pharmacie de Fès, université Sidi Mohamed Ben Abdellah, Fès, Maroc; Service de biochimie-toxicologie, hôpital militaire Moulay Ismail, boulevard Mohamed El Hansali, 50000 Meknès, Maroc.
Service d'ophtalmologie, hôpital militaire Moulay Ismail, Meknès, Maroc; Faculté de médecine et de pharmacie de Rabat, université Mohamed V, Rabat, Maroc.
J Fr Ophtalmol. 2017 May;40(5):394-396. doi: 10.1016/j.jfo.2016.10.018. Epub 2017 Apr 8.
Ocular siderosis is a rare but severe complication of open globe trauma with intraocular retention of a metallic foreign body.
We report a case of recurrent uveitis in a 37-year-old patient. The ophthalmic examination revealed poor vision in the left eye, lid edema, limbal scleromalacia, hyphema and severe ocular hypertension. Orbital CT showed the presence of a radio-opaque IOFB between the crystalline lens and vitreous body. An aqueous humor sample was obtained for iron and ferritin levels. The results came back 100 and 2000 times higher, respectively, than the serum reference values.
The very high iron content is the result of a sustained release from the metallic INFB and is responsible for ocular siderosis in our patient. The extremely high ferritin level would be the result of in situ synthesis by the various cells of the ocular structures in order to preserve the components of the eye. Measurement of these two levels would improve the diagnosis, prognosis and treatment of metallic IOFBs.
眼铁质沉着症是开放性眼球外伤伴眼内金属异物存留的一种罕见但严重的并发症。
我们报告一例37岁患者复发性葡萄膜炎的病例。眼科检查发现左眼视力差、眼睑水肿、角膜缘软化、前房积血和严重的眼压升高。眼眶CT显示晶状体和玻璃体之间存在不透射线的眼内异物。采集房水样本检测铁和铁蛋白水平。结果分别比血清参考值高100倍和2000倍。
极高的铁含量是金属眼内异物持续释放的结果,也是我们患者发生眼铁质沉着症的原因。极高的铁蛋白水平是眼结构的各种细胞原位合成的结果,以保护眼睛的成分。这两种水平的检测将改善金属眼内异物的诊断、预后和治疗。