Cobalt-chromium toxic retinopathy case study

Apel, Warren, Stark, Denis, Stark, Anthony, O'Hagan, Stephen and Ling, Joseph (2013) Cobalt-chromium toxic retinopathy case study. Documenta Ophthalmologica, 126 1: 69-78. doi:10.1007/s10633-012-9356-8

Author Apel, Warren
Stark, Denis
Stark, Anthony
O'Hagan, Stephen
Ling, Joseph
Title Cobalt-chromium toxic retinopathy case study
Journal name Documenta Ophthalmologica   Check publisher's open access policy
ISSN 0012-4486
Publication date 2013-02-01
Sub-type Article (original research)
DOI 10.1007/s10633-012-9356-8
Volume 126
Issue 1
Start page 69
End page 78
Total pages 10
Place of publication Heidelberg, Germany
Publisher Springer
Language eng
Formatted abstract
Purpose: To report the clinical case of a 65-year-old male who developed retinal dysfunction following cobalt-chromium toxicity.

Methods: A review of the clinical, haematological, radiological and electrophysiological investigations into a single patient was performed in order to form a case report.

Results: A 65-year-old male presented to his ophthalmologist with a 1-year history of worsening vision on the background of a multisystem illness including motor axonopathy, pericardiomyopathy and bulbar palsy. His medical history included hypertension, hypercholesterolaemia and a metallic hip prosthesis. Ocular examination revealed significantly reduced visual acuity bilaterally along with very poor colour vision. Cornea, fundi and optic discs all appeared normal. Bilateral moderate nuclear sclerosis was noted. Basic investigations including mitochondrial studies, auto-immune screen and MRI of brain were unremarkable. Further investigations showed significantly elevated plasma cobalt and chromium levels. Electrophysiological studies revealed an abnormality in all phases of the ERG including a negative b-waveform, suggestive of inner retinal pathology. Following subsequent revision of the hip, cobalt and chromium levels decreased and the patient's vision improved. Further electrophysiological testing indicates a persistent ERG abnormality despite a significant improvement in both the patient's visual acuity and colour vision.

Conclusions: These results suggest that cobalt-chromium toxicity can cause inner retinal dysfunction.
Keyword Retinopathy
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 15 December 2012

Document type: Journal Article
Sub-type: Article (original research)
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