| Identifier |
walsh_2014_s3_c1 |
| Title |
Wear and Tear Vision |
| Creator |
Konrad P. Weber; Caterina Schweier; Veronika Kana; Thomas Guggi; Katarzyna Byber; Klara Landau |
| Affiliation |
(KPW) (CS) (KL) Department of Ophthalmology, University Hospital Zurich Zurich, Switzerland; (KPW) (VK) Department of Neurology, University Hospital Zurich Zurich, Switzerland; (TG) Department of Orthopedics, Schulthess Clinic Zurich, Switzerland; (KB) Occupational and Environmental Medicine Division, University of Zurich Zurich, Switzerland |
| Subject |
Visual Loss; Cobalt Toxicity; Hip Prosthesis; Retinopathy; Optic Neuropathy |
| History |
A 66-year-old woman presented with a four-month history of insidious bilateral visual loss. Ophthalmologic examination revealed visual acuity reduced to finger counting in both eyes. On fundus examination, maculae and optic discs appeared normal. Visual fields showed bilateral central scotoma with mainly nasal defects. Past medical history was extensive including type 2 diabetes and coronary artery disease with myocardial hypertrophy. Surgical history included bilateral hip replacements with revision on the left. Review of systems was notable for recurrent depression, fatigue and decreased appetite with weight loss. She also complained of paresthesias in her hands and feet, imbalance, and bilateral hearing loss. Electroretinography (ERG) revealed severe cone dysfunction. Based on the clinical and ERG findings, cancer-associated retinopathy (CAR), melanoma-associated retinopathy (MAR) or autoimmune retinopathy (AIR) was suspected. An extensive tumor screening including brain MRI, FDG-PET-CT and anti-CNS antibodies (including anti-recoverin for CAR) did not reveal any small-cell lung carcinoma, gynecologic tumor, melanoma or other malignancy. Autoimmune screening was negative. Two years after first presentation, the patient consulted an orthopedic surgeon because of chronic left hip pain and muscle tenderness after hip replacement surgery. A diagnostic test was performed. |
| Disease/Diagnosis |
Cobalt neurotoxicity from hip prosthesis abrasion. |
| Presenting Symptom |
A 66-year-old woman presented with a four-month history of insidious bilateral visual loss. |
| Neuroimaging |
Positron Emission Tomography-Computed Tomography; Magnetic Resonance Imaging |
| Date |
2014-03 |
| References |
1. Apel W, Stark D, Stark A, O'Hagan S, Ling J. Cobalt-chromium toxic retinopathy case study. Doc Ophthalmol. 126(1):69-78, 2013. 2. Bhardwaj N, Perez J, Peden M. Optic Neuropathy from Cobalt Toxicity in a Patient who Ingested Cattle Magnets. Neuro-ophthalmology, 35(1), 24-26, 2011. 3. Paustenbach DJ, Tvermoes BE, Unice KM, Finley BL, Kerger BD. A review of the health hazards posed by cobalt. Crit Rev Toxicol. 43(4):316-62, 2013. 4. Rizzetti MC, Zarattini G, Pazzaglia U, Padovani A. Blind and deaf after total hip replacement? Author reply. Lancet. 373(9679):1944-5, 2009. 5. Allain J, Roudot-Thoraval F, Delecrin J, Anract P, Migaud H, et al. Revision total hip arthroplasty performed after fracture of a ceramic femoral head. A multicenter survivorship study. J Bone Joint Surg Am. 85- A(5):825-30, 2003. |
| Language |
eng |
| Format |
application/pdf |
| Type |
Image |
| Source |
46th Annual Frank Walsh Society Meeting |
| Relation is Part of |
Case presented at the NANOS 2014 Walsh Session, March 2 |
| Collection |
Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-6293 |
| Rights Management |
Copyright 2014. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6962f49 |
| Setname |
ehsl_novel_fbw |
| ID |
179203 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6962f49 |
