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Case Reports
. 2012:6:2033-6.
doi: 10.2147/OPTH.S37898. Epub 2012 Dec 5.

Ocular argyrosis secondary to long-term ingestion of silver nitrate salts

Kesenia Stafeeva  1 , Michael Erlanger, Raul Velez-Montoya, Jeffrey L Olson
Affiliations
Case Reports

Ocular argyrosis secondary to long-term ingestion of silver nitrate salts

Kesenia Stafeeva et al. Clin Ophthalmol. 2012.

Abstract

This case report describes the clinical, autofluorescence, and optical coherent tomography findings in a patient with panocular argyrosis secondary to chronic intake of diluted silver nitrate salts in his water supply. An 86-year-old Caucasian male with a distinctive gray-bluish hue of the skin presented to our clinic, having developed a slow decrease in visual acuity in both eyes and nyctalopia for the past 2 years. Based on the patient's history of chronic intake of silver nitrate salts and a positive skin biopsy (performed by the dermatology department, data not shown), a diagnosis of panocular argyrosis was made. Fluorescein angiography showed choroidal blockage with a completely dark choroid. Fundus autofluorescence was within normal limits. Optical coherent tomography showed multiple excrescences of retinal pigment epithelium in both eyes. Although the drusen-like changes on fundus examination and retinal pigment epithelium changes may account for the diminished vision, the presence of concomitant nyctalopia suggests underlying damage of the photoreceptors.

Keywords: argyria; fundus autofluorescence; ocular argyrosis; optical coherent tomography; silver nitrate.

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Figures

Figure 1
Figure 1
Clinical picture of the patient’s face showing the gray-bluish hue of the skin of the face, scalp, and neck (A), including the periocular region, conjunctiva, and sclera (B).
Figure 2
Figure 2
Fundus color photographs and early and late phases of fluorescein angiography. Notes: In the color photographs, there is evidence of pigmentary changes at the level of the retinal pigmented epithelium and drusen formation in both macula. Fluorescein angiography shows early and late hyperfluorescence probably due to the aforementioned changes.
Figure 3
Figure 3
Fundus autofluorescence images (A and B) and optical coherent tomography images (C and D). Notes: The images show no evidence of metabolic dysfunction in the retinal pigmented epithelium. Optical coherence tomography shows small pigment epithelial detachments secondary to drusen.
See this image and copyright information in PMC

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