Argirose ocular e do sistema lacrimal excretor: relato de caso

Clinical and Forensic Aspects of the Different Subtypes of Argyria

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition ( Figure 5 ) that can occur in GA [ 6 , 34 , 47 , 49 , 54 , 111 , 112 ], but also as a LA form [ 113 , 114 , 115 , 116 ]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [ 113 , 114 , 117 , 118 , 119 , 120 ]. Its appearance ranges from small, darker lesions to a more disperse tinge, somewhat parallelly to LA and GA, and with greater heterogeneity concerning coloration, as greenish and brownish tones might be displayed other than the typical gray/blue [ 121 , 122 ].…”

“…In the eye, silver deposits exhibit a clear predilection for corneal Descemet’s membrane, but it can also be found in Bowman’s membrane, the stromal tissue in-between, both bulbar and palpebral conjunctiva and the lacrimal caruncle [ 25 , 58 , 102 , 113 , 149 , 150 , 151 , 152 ]. When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [ 114 , 153 , 154 ]. Reports of crystalline lens silver deposits have also been made [ 54 , 114 , 149 , 155 ].…”

“…Patients with OA have reported visual symptoms, most commonly nyctalopia [ 54 ], and presented with concomitant comorbidities, such as glaucoma [ 151 , 163 ], cataract [ 114 , 149 , 218 , 262 ], diabetic retinopathy [ 111 ], as well as posterior eye segment changes somewhat coherent with the functional complaints [ 157 , 158 ], but without direct link to the silver deposition itself [ 156 , 162 , 263 ]. This inconsistency, alongside several OA patients lacking any visual complaints, has contributed to some consensus regarding the seemingly innocuous silver deposition in the eye, though this claim still needs a more robust foundation [ 21 , 113 , 261 , 263 , 264 ].…”

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition (Figure 5) that can occur in GA [6,34,47,49,54,111,112], but also as a LA form [113][114][115][116]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [113,114,[117][118][119][120].…”

“…When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [114,153,154]. Reports of crystalline lens silver deposits have also been made [54,114,149,155]. In the posterior segment of the eye, silver accumulation is speculated about, following reports of retinal pigment epithelium changes, drusenoid deposits, and dark choroids in fluorescein angiogram, but a necessary causal relationship was not yet clearly established [111,[156][157][158].…”

Clinical and Forensic Aspects of the Different Subtypes of Argyria

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition ( Figure 5 ) that can occur in GA [ 6 , 34 , 47 , 49 , 54 , 111 , 112 ], but also as a LA form [ 113 , 114 , 115 , 116 ]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [ 113 , 114 , 117 , 118 , 119 , 120 ]. Its appearance ranges from small, darker lesions to a more disperse tinge, somewhat parallelly to LA and GA, and with greater heterogeneity concerning coloration, as greenish and brownish tones might be displayed other than the typical gray/blue [ 121 , 122 ].…”

“…In the eye, silver deposits exhibit a clear predilection for corneal Descemet’s membrane, but it can also be found in Bowman’s membrane, the stromal tissue in-between, both bulbar and palpebral conjunctiva and the lacrimal caruncle [ 25 , 58 , 102 , 113 , 149 , 150 , 151 , 152 ]. When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [ 114 , 153 , 154 ]. Reports of crystalline lens silver deposits have also been made [ 54 , 114 , 149 , 155 ].…”

“…Patients with OA have reported visual symptoms, most commonly nyctalopia [ 54 ], and presented with concomitant comorbidities, such as glaucoma [ 151 , 163 ], cataract [ 114 , 149 , 218 , 262 ], diabetic retinopathy [ 111 ], as well as posterior eye segment changes somewhat coherent with the functional complaints [ 157 , 158 ], but without direct link to the silver deposition itself [ 156 , 162 , 263 ]. This inconsistency, alongside several OA patients lacking any visual complaints, has contributed to some consensus regarding the seemingly innocuous silver deposition in the eye, though this claim still needs a more robust foundation [ 21 , 113 , 261 , 263 , 264 ].…”

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition (Figure 5) that can occur in GA [6,34,47,49,54,111,112], but also as a LA form [113][114][115][116]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [113,114,[117][118][119][120].…”

“…When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [114,153,154]. Reports of crystalline lens silver deposits have also been made [54,114,149,155]. In the posterior segment of the eye, silver accumulation is speculated about, following reports of retinal pigment epithelium changes, drusenoid deposits, and dark choroids in fluorescein angiogram, but a necessary causal relationship was not yet clearly established [111,[156][157][158].…”

Clinical and Forensic Aspects of the Different Subtypes of Argyria

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition ( Figure 5 ) that can occur in GA [ 6 , 34 , 47 , 49 , 54 , 111 , 112 ], but also as a LA form [ 113 , 114 , 115 , 116 ]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [ 113 , 114 , 117 , 118 , 119 , 120 ]. Its appearance ranges from small, darker lesions to a more disperse tinge, somewhat parallelly to LA and GA, and with greater heterogeneity concerning coloration, as greenish and brownish tones might be displayed other than the typical gray/blue [ 121 , 122 ].…”

“…In the eye, silver deposits exhibit a clear predilection for corneal Descemet’s membrane, but it can also be found in Bowman’s membrane, the stromal tissue in-between, both bulbar and palpebral conjunctiva and the lacrimal caruncle [ 25 , 58 , 102 , 113 , 149 , 150 , 151 , 152 ]. When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [ 114 , 153 , 154 ]. Reports of crystalline lens silver deposits have also been made [ 54 , 114 , 149 , 155 ].…”

“…Patients with OA have reported visual symptoms, most commonly nyctalopia [ 54 ], and presented with concomitant comorbidities, such as glaucoma [ 151 , 163 ], cataract [ 114 , 149 , 218 , 262 ], diabetic retinopathy [ 111 ], as well as posterior eye segment changes somewhat coherent with the functional complaints [ 157 , 158 ], but without direct link to the silver deposition itself [ 156 , 162 , 263 ]. This inconsistency, alongside several OA patients lacking any visual complaints, has contributed to some consensus regarding the seemingly innocuous silver deposition in the eye, though this claim still needs a more robust foundation [ 21 , 113 , 261 , 263 , 264 ].…”

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition (Figure 5) that can occur in GA [6,34,47,49,54,111,112], but also as a LA form [113][114][115][116]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [113,114,[117][118][119][120].…”

“…When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [114,153,154]. Reports of crystalline lens silver deposits have also been made [54,114,149,155]. In the posterior segment of the eye, silver accumulation is speculated about, following reports of retinal pigment epithelium changes, drusenoid deposits, and dark choroids in fluorescein angiogram, but a necessary causal relationship was not yet clearly established [111,[156][157][158].…”

Clinical and Forensic Aspects of the Different Subtypes of Argyria

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition ( Figure 5 ) that can occur in GA [ 6 , 34 , 47 , 49 , 54 , 111 , 112 ], but also as a LA form [ 113 , 114 , 115 , 116 ]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [ 113 , 114 , 117 , 118 , 119 , 120 ]. Its appearance ranges from small, darker lesions to a more disperse tinge, somewhat parallelly to LA and GA, and with greater heterogeneity concerning coloration, as greenish and brownish tones might be displayed other than the typical gray/blue [ 121 , 122 ].…”

“…In the eye, silver deposits exhibit a clear predilection for corneal Descemet’s membrane, but it can also be found in Bowman’s membrane, the stromal tissue in-between, both bulbar and palpebral conjunctiva and the lacrimal caruncle [ 25 , 58 , 102 , 113 , 149 , 150 , 151 , 152 ]. When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [ 114 , 153 , 154 ]. Reports of crystalline lens silver deposits have also been made [ 54 , 114 , 149 , 155 ].…”

“…Patients with OA have reported visual symptoms, most commonly nyctalopia [ 54 ], and presented with concomitant comorbidities, such as glaucoma [ 151 , 163 ], cataract [ 114 , 149 , 218 , 262 ], diabetic retinopathy [ 111 ], as well as posterior eye segment changes somewhat coherent with the functional complaints [ 157 , 158 ], but without direct link to the silver deposition itself [ 156 , 162 , 263 ]. This inconsistency, alongside several OA patients lacking any visual complaints, has contributed to some consensus regarding the seemingly innocuous silver deposition in the eye, though this claim still needs a more robust foundation [ 21 , 113 , 261 , 263 , 264 ].…”

“…Argyrosis is a particular argyric manifestation evidenced by the ocular silver deposition (Figure 5) that can occur in GA [6,34,47,49,54,111,112], but also as a LA form [113][114][115][116]. It is mostly detected in the cornea, bulbar and palpebral conjunctivae, and lacrimal caruncle [113,114,[117][118][119][120].…”

“…When the lacrimal sac is visualized (following dacryocystectomy), it often displays the pigmentation as well and in a striking fashion, with a strong black tone [114,153,154]. Reports of crystalline lens silver deposits have also been made [54,114,149,155]. In the posterior segment of the eye, silver accumulation is speculated about, following reports of retinal pigment epithelium changes, drusenoid deposits, and dark choroids in fluorescein angiogram, but a necessary causal relationship was not yet clearly established [111,[156][157][158].…”