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Journal Français d'Ophtalmologie
Volume 37, n° 9
pages e145-e146 (novembre 2014)
Doi : 10.1016/j.jfo.2014.02.013
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Asteroid hyalosis in Congolese patients
La dégénérescence astéroïde du vitré chez les patients congolais

D. Kaimbo Wa Kaimbo
 Department of Ophthalmology, University of Kinshasa, BP 16540, Kinshasa, The Democratic Republic of the Congo 

Asteroid hyalosis (AH), also referred to as asteroid hyalitis, asteroid bodies, or scintillation nivea, was first described by Benson in 1894 [1, 2] and is a degenerative process resulting in small, white vitreous opacities consisting of calcium phosphate and complex, layered lipid deposits. This degenerative condition appears clinically as yellow-white spherical bodies floating in the vitreous gel in chains or sheets, without visual compromise [3, 4]. Other vitreous abnormalities may include synchysis scintillans, inflammatory cells and amyloidosis. In synchysis scintillans, the vitreous opacities are noted when frank haemorrhage is no longer present and appear as flat, golden brown, refractile bodies that are freely mobile. The presence of inflammatory cells within the vitreous is secondary to active inflammation at an adjacent site. The opacities in amyloidosis initially are granular, with wispy fringes, and later take on a “glass wool” appearance [5].

Although epidemiological studies of AH have been reported in Caucasians and Asians, there is no data available on prevalence of AH in black Africans. The purpose of the study was to determine the frequency and clinical characteristics of AH in Congolese patients.

We performed a retrospective cross-sectional and descriptive analysis of the data collected between January 2005 and August 2012 from patients diagnosed with AH, in an outpatient eye clinic, a general ophthalmology practice. After a complete examination, the pupils were dilated with tropicamide 0.5% and phenylephrine 10% for ophthalmoscopy and fundus photography. The diagnosis of AH was made in presence of cream-white spherical bodies within the vitreous, as seen in indirect ophthalmoscopy.

Out of 7721 patients40 years old seen during the study period, 18 (20 eyes) were diagnosed with AH, giving a frequency of 0.23%. The mean age of the patients with AH was 61.33 years±10 (SD) (range, 40 to 78 years). We found greater rates of frequency with increasing age: 0.09% of patients aged 40–49 years had AH, whereas 0.45% of those aged more or equal to 70 years were affected. Fifteen (83%) of the patients with AH were men and 3 (17%) were women. Men were more frequently diagnosed with AH than women (0.35% versus 0.04% of men, P <0.05). Unilateral AH was found in 80%. Senile cataract, open angle glaucoma and age-related macular degeneration were found in eight (44.4%), four (22.2%) and two (11.1%) patients respectively. Diabetes mellitus, hypertension, gout and prostate cancer were systemic associated condition found in 6 (33.3%), 6 (33.3%) patients, one (5.6%) and one (5.6%) patient respectively.

The etiology of AH is not clearly understood. The disease is very uncommon with a male-to-female ratio of 2:1. The risk factors very frequent are related to vascular diseases and lipidic anomalities. The results found in our study are almost similar and close to the previously reported studies [2, 6, 7, 8, 9].

To the best of our knowledge, this study is the first to report AH in black patients from Africa. The frequency of 0.23% of AH found in this study, although relatively low, is comparable to prevalence reported in previous population- and non-population-based studies in Caucasians and Asians [2, 6, 7, 8, 9], ranging from 0.28 to 1.98%.

As expected and reported in prior studies from Caucasians and Asians [7, 8], the frequency of AH, in our study, increased with aging, confirming the idea that the prevalence of AH increases with age. The condition appears to occur more frequently in men than in women, as shown in many previous reports [7, 8] and found in our study.

In conclusion, despite the limitations inherent in a clinic-based study, this study provides information of the frequency of AH in Central Africa. This study confirms that AH affects all races, is an age-related condition and is found more in men. The patients with AH must be followed-up with attention because the cataract or vitreous surgeries might be difficult when there is a vitreous lost. The retinal detachment can occur more easily because of this vitreous anomaly.

Disclosure of interest

The author declares that he has no conflict of interest concerning this article.

 Text issued of an oral presentation during the 119th Congress of the French Society of Ophthalmology in May 2013.


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