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Giant Macular Hole in Alport Syndrome
Pictures & Perspectives Giant Macular Hole in Alport Syndrome A 33-year-old man had an 8-month history of gradually progressive decrease in vision of left eye. There was no pertinent past ocular history or trauma. He also suffered from sensorineural hearing loss. Urine examination showed microscopic hematuria. Kidney biopsy showed thickening of the glomerular basement membrane consistent with Alport syndrome. The fundus and optical coherence tomography image demonstrated giant macular hole (approximately 1500 microns) formation (Fig 1A, B). Alport syndrome-associated macular holes seem to be distinguished from idiopathic holes by their tendency for larger size and an earlier age at onset.
CAGATAY CAGLAR, MD1 HAKAN TIRHIS, MD2 PELIN YILMAZBAS, MD2 1 Department of Ophthalmology, Faculty of Medicine, Hitit University, Corum, Turkey; 2Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
Posterior Segment Findings in Vitamin A Deficiency A 48-year-old white woman was referred to our eye institute for night vision that had gradually worsened in the course of 1 year. Her medical history is notable for gastric bypass surgery 13 years prior with subsequent 100-pound weight loss. Dilated fundus examination showed a granular appearance created by multiple punctate dots extending throughout the posterior pole and midperiphery. Ocular coherence tomography results showed a jagged ellipsoid line with focal hyperreflective excrescences localizing to the spots seen on fundus examination. The patient’s serum vitamin A level was severely deficient at <0.06 mg/L. She was started on high-dose vitamin A supplementation and experienced subsequent subjective improvement.
SHRIJI PATEL, MD Vanderbilt Eye Institute, Nashville, Tennessee
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CAGATAY CAGLAR, MD1 HAKAN TIRHIS, MD2 PELIN YILMAZBAS, MD2 1 Department of Ophthalmology, Faculty of Medicine, Hitit University, Corum, Turkey; 2Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
Posterior Segment Findings in Vitamin A Deficiency A 48-year-old white woman was referred to our eye institute for night vision that had gradually worsened in the course of 1 year. Her medical history is notable for gastric bypass surgery 13 years prior with subsequent 100-pound weight loss. Dilated fundus examination showed a granular appearance created by multiple punctate dots extending throughout the posterior pole and midperiphery. Ocular coherence tomography results showed a jagged ellipsoid line with focal hyperreflective excrescences localizing to the spots seen on fundus examination. The patient’s serum vitamin A level was severely deficient at <0.06 mg/L. She was started on high-dose vitamin A supplementation and experienced subsequent subjective improvement.
SHRIJI PATEL, MD Vanderbilt Eye Institute, Nashville, Tennessee
173