Bilateral acute depigmentation of the iris in two siblings simultaneously

Amin, Rana Hussein; Nabih, Amena; Khater, Noha

doi:10.1016/j.ajoc.2018.03.016

Cited by 10 publications

(15 citation statements)

References 20 publications

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“…This etiology of this condition is unknown, and only a few cases have been reported in the literature. The initial cases of BADI were reported in Turkey [1,2], however, recently cases have been reported in both Brazil [3] and Egypt [4]. In our case we report a woman who developed BADI after receiving pitcher plant extract injections for chronic migraine, while her identical twin sister has normal iris architecture and pigmentation, and never received any pitcher plant extract injections.…”

Section: Introductionmentioning

confidence: 72%

“…Upon review of the cases of BADI, including ours, we noted one important clinical feature which is a maintenance of iris pigmentation within 1-2 mm of the pupil margin. The majority of cases presented in the literature had this common clinical feature [1][2][3][4]. BADI is also easily mistaken for iridocyclitis but given the absence of uveitis symptoms and a different pattern of depigmentation, it is a condition which should be readily made clinically.…”

Section: Discussionmentioning

confidence: 99%

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A case of bilateral acute depigmentation of the Iris in one of two identical twins

2020

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Background: Bilateral Acute Depigmentation of the Iris (BADI) is a condition which was first described in a case series from Turkey by Tugal-Tutkin and Urgancioglu in (Graefes Arch Clin Exp Ophthalmol 244:742-6, 2006). The condition is characterized by bilateral acute depigmentation and discoloration of the iris stroma, pigment dispersion, and deposition of pigment in the angle. In our case we report a patient who developed BADI after receiving pitcher plant extract injections for chronic migraine, while her identical twin sister has normal iris architecture and pigmentation and never received any pitcher plant injections. Case presentation: Patient is a 41-year-old female with history of pitcher plant extract injections to her face for chronic migraine, who later developed bilateral depigmentation of the iris. She did not have any signs of anterior segment uveitis or iridocyclitis. She has an identical twin sister who maintained normal iris pigmentation during the entire course. Conclusions: Bilateral Acute depigmentation of the is a recently discovered condition described in the literature in Turkish patients (Tugal-Tutkun and Urgancioglu, Graefes Arch Clin Exp Ophthalmol 244: 742-6, 2006; Tugal-Tutkun et al., Ophthalmology 116(8):1552-7, 2009). This condition affects mainly young females and is characterized by acute bilateral stromal depigmentation, without other pathologic ocular findings. These patients usually maintain normal vision and do not develop significant glaucoma from pigment collecting in the anterior chamber angle. This condition can be mistaken for Fuchs' heterochromic iridocyclitis, pigment dispersion syndrome, pseudoexfoliation syndrome, and viral iridocyclitis. This is the first reported case in North America and is important for differentiation from the above pathologies. Our patient had a history of pitcher plant extract injections to the face but it is unclear if this is associated with our patient's development of BADI. As awareness of this condition progresses, a possible etiology may be elucidated.

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Section: Introductionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

A case of bilateral acute depigmentation of the Iris in one of two identical twins

2020

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“…Upon review of the cases of BADI, including ours, we noted one important clinical feature which is a maintenance of iris pigmentation within 1-2mm of the pupil margin. The majority of cases presented in the literature had this common clinical feature [1][2][3][4] . BADI is also easily mistaken for iridocyclitis but given the absence of uveitis symptoms and a different pattern of depigmentation, it is a condition which should be readily made clinically.…”

Section: Discussionmentioning

confidence: 99%

“…This etiology of this condition is unknown, and only a few cases have been reported in the literature. The initial cases of BADI were reported in Turkey 1,2 , however, recently cases have been reported in both Brazil 3 and Egypt 4 . In our case we report a woman who developed BADI after receiving pitcher plant extract injections for chronic migraine, while her identical twin sister has normal iris architecture and pigmentation, and never received any pitcher plant extract injections.…”

Section: Introductionmentioning

confidence: 99%

A Case of Bilateral Acute Depigmentation of the Iris in One of Two Identical Twins

Langevin

Gershkovich

Marr³

2019

Preprint

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Background: Bilateral Acute Depigmentation of the Iris (BADI) is a condition which was first described in a case series from Turkey by Tugal-Tutkin and Urgancioglu in 2006.1 The condition is characterized by bilateral acute depigmentation and discoloration of the iris stroma, pigment dispersion, and deposition of pigment in the angle. In our case we report a patient who developed BADI after receiving pitcher plant extract injections for chronic migraine, while her identical twin sister has normal iris architecture and pigmentation and never received any pitcher plant injections. Case Presentation: Patient is a 41-year-old female with history of pitcher plant extract injections to her face for chronic migraine, who later developed bilateral depigmentation of the iris. She did not have any signs of anterior segment uveitis or iridocyclitis. She has an identical twin sister who maintained normal iris pigmentation during the entire course. Discussions and Conclusion: Bilateral Acute depigmentation of the is a recently discovered condition described in the literature in Turkish patients1,2. This condition affects mainly young females and is characterized by acute bilateral stromal depigmentation, without other pathologic ocular findings. These patients usually maintain normal vision and do not develop significant glaucoma from pigment collecting in the anterior chamber angle. This condition can be mistaken for Fuchs’ heterochromic iridocyclitis, pigment dispersion syndrome, pseudoexfoliation syndrome, and viral iridocyclitis. This is the first reported case in North America and is important for differentiation from the above pathologies. Our patient had a history of pitcher plant extract injections to the face but it is unclear if this is associated with our patient’s development of BADI. As awareness of this condition progresses, a possible etiology may be elucidated.

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“…Авторы исследования описывают данное заболевание одновременно у двух братьев и сестер. Кроме генетической имеется предположение об инфекционной природе заболевания [22,23].…”

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Causes of Iris Depigmentation in Young and Middle Age. Clinical Example

et al. 2020

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The spontaneous change of eyes’ color is a quite rare complain in ophthalmological clinical practice for young and middle-aged patients. We consulted the 18-year-old patient complained that a month ago she noticed a change of the iris’ color. It was symmetrical in both eyes, which had lightened and acquired a “spotty appearance”. Before the appearance of these complaints, the patient had eyes of a rich dark brown color. After a comprehensive examination, the bilateral acute iris depigmentation (BADI) was diagnosed. BADI is bilateral symmetrical iris depigmentation followed by focal or diffuse stromal atrophy and pigment dispersion in the anterior segment. It is more common for young and middle-aged women, and is often asymptomatic. BADI has bilateral symmetrical iris depigmentation followed by focal or diffuse stromal atrophy and pigment dispersion in the anterior eye segment of the eye, which may affect the trabecular network. A feature of this disease is the absence of transillumination, changes in the shape of the pupil, and an inflammatory reaction. In some cases, repigmentation may occur spontaneously during the next few years. Therefore, from a prognostic point this disease has a favorable prognosis. However, patients with BADI syndrome should undergo regular ophthalmological examinations, including measurement of intraocular pressure to exclude the development of secondary open-angle pigmented glaucoma, and use sunglasses when the sun is bright. BADI syndrome must be differentiated with the following diseases: Fuchs heterochromic iridocyclitis, viral iridocyclitis caused by HSV and CMV, pigment dispersion syndrome and pseudo exfoliative glaucoma, as well as bilateral acute iris transillumination (BAIT) syndrome to make a correct diagnosis and apply adequate treatment tactics.

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Bilateral acute depigmentation of the iris in two siblings simultaneously

Cited by 10 publications

References 20 publications

A case of bilateral acute depigmentation of the Iris in one of two identical twins

A case of bilateral acute depigmentation of the Iris in one of two identical twins

A Case of Bilateral Acute Depigmentation of the Iris in One of Two Identical Twins

Causes of Iris Depigmentation in Young and Middle Age. Clinical Example

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