Functional and high resolution retinal imaging assessment in a case of ocular siderosis

To report new findings in a case of ocular siderosis explored by high resolution angiography and adaptive optics (AO). We report data on a 40-year-old man with an intraocular foreign body (IOFB) embedded in the sclera after hammering. Nine months after this accident, the patient presented with full-field electroretinogram (FF-ERG) abnormalities. Subsequent IOFB extraction was performed. One month after the surgery, high resolution angiography showed for the first time small iron particles all over the inner retinal surface. Spreading of these deposits was followed by inflammatory prepapillary new vessels and venous retinal vasculatis, which spontaneously resolved within a few months. ERG responses became slightly electronegative at this time. Clearance of the iron particles was followed over a year with AO and ERG recording. AO revealed an arterial tropism with a decrease in the amount of particles overtime, which may be consistent with macrophagic activity. High resolution angiography and AO are new tools, combined with electrophysiology, to better understand ocular siderosis pathophysiology.