Evaluation of Kayser-Fleischer ring in Wilson disease by anterior segment optical coherence tomography

Indian J Ophthalmol. 2017 May;65(5):354-357. doi: 10.4103/ijo.IJO_400_16.

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.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Eye Segment / metabolism
  • Anterior Eye Segment / pathology*
  • Child
  • Copper / metabolism
  • Corneal Diseases / diagnosis*
  • Corneal Diseases / etiology
  • Corneal Diseases / metabolism
  • Female
  • Follow-Up Studies
  • Hepatolenticular Degeneration / complications
  • Hepatolenticular Degeneration / diagnosis*
  • Hepatolenticular Degeneration / metabolism
  • Humans
  • Male
  • Retrospective Studies
  • Slit Lamp Microscopy
  • Tomography, Optical Coherence / methods*
  • Young Adult

Substances

  • Copper