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

Abstract

Kesenia Stafeeva, Michael Erlanger, Raul Velez-Montoya, Jeffrey L OlsonDepartment of Ophthalmology, University of Colorado School of Medicine, Rocky Mountain Lions Eye Institute, Colorado, CO, USAAbstract: 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: silver nitrate, argyria, ocular argyrosis, fundus autofluorescence, optical coherent tomography