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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2006, Number 3

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Rev Mex Oftalmol 2006; 80 (3)

Argirosis corneal

Sánchez-Huerta V, De Wit-Carter G, Hernández-Quintela E, Rodríguez-Reyes AA, Naranjo-Tackman R

Language: Spanish
References: 30
Page: 150-156
PDF size: 638.75 Kb.


ABSTRACT

Purpose: To determine the value of confocal and specular microscopy in the examination of corneal argyrosis in silversmiths. A severity classification based on clinical signs is proposed.
Methods: Nine patients with corneal argyrosis underwent a complete physical and ophthalmologic examination. Specular and confocal microscopy was performed in all cases. Conjunctiva specimen of two patients and a trabecular biopsy of one patient were examined histologicaly. Time of exposure to silver and the density of the deposits were correlated with clinical signs.
Results: Slit-lamp examination showed gray, diffuse opacities in the deep corneal stroma. Confocal microscopy showed highly reflective deposits with a granular pattern anterior to the corneal endothelium and hypereflective keratocyte nuclei with visible cytoplasm in the anterior stroma. Specular microscopy demonstrated round white bodies anterior to the corneal endothelium. Silver deposits were not found histologicaly. The clinical correlation between time of exposure and density of silver deposits was set in grades making a clinical classification.
Conclusions: Silversmiths with long-term exposure to silver compounds are at high risk of developing corneal argyrosis. We conclude that specular microscopy and in vivo confocal microscopy provided important information for the diagnosis of corneal argyrosis. A clinical classification of corneal argyrosis is proposed.


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