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Yellow corneal ring associated with vitamin supplementation for age-related macular degeneration.

ABSTRACT: To report the first described cases of peripheral yellow corneal rings secondary to vitamin supplementation for age-related macular degeneration (ARMD).Retrospective single-center case series.The eyes of 4 patients taking vitamin supplementation for ARMD were examined at the University of Pittsburgh Medical Center Department of Ophthalmology between January 2010 and April 2011.We reviewed the medical records of 4 patients with peripheral corneal rings receiving vitamin supplementation for ARMD.The presence of peripheral yellow corneal rings, skin findings, and serum carotene levels.Each patient had circumferential, yellow, peripheral corneal rings and exhibited subtle yellowing of the skin most notable on the palms. Serum carotene levels were normal in 2 of the 3 patients and markedly elevated in the last patient in whom it was measured.It is unclear at this time how to counsel patients with this ocular finding. We suspect that these rings are more common than generally appreciated because they may have a subtle appearance or be misdiagnosed as arcus senilis. We suggest that a formal study be performed on a cohort of patients taking vitamin supplementation for macular degeneration that specifically screens for yellow rings and measures serum carotene levels when they are identified.

SUBMITTER: Eller AW

PROVIDER: S-EPMC3505612 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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Yellow corneal ring associated with vitamin supplementation for age-related macular degeneration.

Eller Andrew W AW Gorovoy Ian R IR Mayercik Vera A VA

Ophthalmology 20120211 5

<h4>Purpose</h4>To report the first described cases of peripheral yellow corneal rings secondary to vitamin supplementation for age-related macular degeneration (ARMD).<h4>Design</h4>Retrospective single-center case series.<h4>Participants</h4>The eyes of 4 patients taking vitamin supplementation for ARMD were examined at the University of Pittsburgh Medical Center Department of Ophthalmology between January 2010 and April 2011.<h4>Methods</h4>We reviewed the medical records of 4 patients with p ...[more]

PMID: 22330962

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Project description:Age-related macular degeneration (AMD) is the leading cause of blindness in the Western world. AMD is a multifactorial disorder but complement-mediated inflammation at the level of the retina plays a pivotal role. Oral zinc supplementation can reduce the progression of AMD but the precise mechanism of this protective effect is as yet unclear. We investigated whether zinc supplementation directly affects the degree of complement activation in AMD and whether there is a relation between serum complement catabolism during zinc administration and the complement factor H (CFH) gene or the Age-Related Maculopathy susceptibility 2 (ARMS2) genotype. In this open-label clinical study, 72 randomly selected AMD patients in various stages of AMD received a daily supplement of 50 mg zinc sulphate and 1 mg cupric sulphate for three months. Serum complement catabolism-defined as the C3d/C3 ratio-was measured at baseline, throughout the three months of supplementation and after discontinuation of zinc administration. Additionally, downstream inhibition of complement catabolism was evaluated by measurement of anaphylatoxin C5a. Furthermore, we investigated the effect of zinc on complement activation in vitro. AMD patients with high levels of complement catabolism at baseline exhibited a steeper decline in serum complement activation (p<0.001) during the three month zinc supplementation period compared to patients with low complement levels. There was no significant association of change in complement catabolism and CFH and ARMS2 genotype. In vitro zinc sulphate directly inhibits complement catabolism in hemolytic assays and membrane attack complex (MAC) deposition on RPE cells. This study provides evidence that daily administration of 50 mg zinc sulphate can inhibit complement catabolism in AMD patients with increased complement activation. This could explain part of the mechanism by which zinc slows AMD progression.The Netherlands National Trial Register NTR2605.

Dataset Information

Yellow corneal ring associated with vitamin supplementation for age-related macular degeneration.

Publications

Yellow corneal ring associated with vitamin supplementation for age-related macular degeneration.

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