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Resolution of Kayser–Fleischer ring in Wilson disease

Khurana, Surbhi; Gupta, Parul Chawla; Ram, Jagat

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Indian Journal of Ophthalmology: October 2019 - Volume 67 - Issue 10 - p 1724
doi: 10.4103/ijo.IJO_957_19
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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[1] but can also be seen in chronic active hepatitis, primary biliary cirrhosis, hepatocellular disorders, and intraocular foreign body containing copper.[2]

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Figure 1:
(a) Kayser–Fleischer ring, seen as circumferential green pigment deposition at the level of Descemet's membrane, before treatment. (b) Decrease in KF ring after treatment

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 The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.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

Nil.

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
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
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