A long-term follow-up of metallic intraocular foreign bodies, employing diagnostic x-ray spectrometry
R. Neumann, M. Belkin, E. Loewenthal and R. Gorodetsky
Maurice and Gabriela Goldschleger Eye Research Institute, Tel-Aviv University, Israel.
We describe 10 eyes harboring metallic intraocular foreign bodies (IOFBs)
for 9 to 46 years that had undergone diagnostic x-ray spectrometry to
measure metal dissolution 9 years before this study. Findings from the
present clinical and laboratory examinations, including perimetry,
electroretinography, electrooculography, and diagnostic x-ray spectrometry
examinations are reported. Deterioration in visual acuity consequent to
metal dissolution of the IOFB was found in only one eye. Visual fields and
electrophysiologic performances deteriorated in two other eyes for reasons
that were probably unrelated to IOFB dissolution. Visual functions remained
stable during the follow-up period in seven eyes, although excess copper
levels were demonstrated in one of them. Eight of 10 eyes retained visual
acuity of 6/24 or better. Diagnostic x-ray spectrometry confirmed siderosis
in one patient and ruled out metallosis in the two patients with
deteriorated vision for reasons that were unrelated to metallosis. The
favorable outcome of this series of patients may influence one to consider
a more conservative approach in the decision to remove IOFBs. A careful,
life-long follow-up might be considered with periodic electroretinographic
and diagnostic x-ray spectrometry examinations; the IOFB should be promptly
removed if and when metallosis with damage to visual functions is
demonstrated.
