Resolution of Kayser–Fleischer ring in Wilson disease
A 6-year-old child with Wilson disease and autoimmune hepatitis presented to cornea clinic for routine ocular examination with unaided vision of 20/20 OU. Microscopic slit lamp examination revealed bilateral thick, circumferential green copper deposition on Descemet's membrane of the cornea suggestive of Kayser–Fleischer (KF) ring [Fig. 1a]. After being treated with penicillamine, oral steroids, and immunosuppression for 1 year, KF ring had decreased significantly [Fig. 1b]. KF ring is most commonly seen in Wilson disease but can also be seen in chronic active hepatitis, primary biliary cirrhosis, hepatocellular disorders, and intraocular foreign body containing copper.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
1. Sullivan CA, Chopdar A, Shun-Shin GA. Dense Kayser-Fleischer ring in asymptomatic Wilson's disease (hepatolenticular degeneration) Br J Ophthalmol. 2002;86:114
© 2019 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow
2. Frommer D, Morris J, Sherlock S, Abrams J, Newman S. Kayser-Fleischer like rings in patients without Wilson's disease Gastroenterology. 1977;72:1331–5