Retinal evaluation by fundus angiography before and after vitrectomy and foreign body removal in a patient with ocular siderosis: a case report

BACKGROUND: Ocular siderosis (OS) is a rare severe complication arising from retained iron-containing intraocular foreign bodies. In the young male patient reported in this paper, the intraretinal diffusion and distribution of siderotic particles before and after the removal of the foreign body were observed via fundus angiography (FA). CASE DESCRIPTION: A 33-year-old decoration worker was diagnosed as the absolute stage of right eye glaucoma in the local hospital and was treated with cataprolol and brinzolamide eye liquid to reduce intraocular pressure. The symptoms did not improve. He came to our hospital for treatment. He was finally diagnosed with “foreign body, siderosis, and secondary glaucoma in the right eye” based on eye examinations. According to the observation via fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), grade 2–3 vascular occlusion extended in a gradient along the foreign body, there was no retinal perfusion in the temporal retina, the siderotic particles were distributed along the artery, and inflammatory changes occurred in the optic nerve and retinal vein. He underwent pars plana vitrectomy, foreign body removal, retinal laser photocoagulation, silicone oil filling and pressure reducing valve implantation. Silicone oil was removed three months later. The postoperative visual acuity was not improved, the intraocular pressure was well controlled, and there was concurrent cataract, but it did not affect the fundus examination. At 3 and 10 months after operation, the fundus angiography showed that the particles distributed along the artery decreased, the inflammation of optic nerve and retinal vein subsided, and the laser spots in the non perfusion area were clear. CONCLUSIONS: The influence of iron ion on retinal vein and the distribution of iron ion along retinal artery can be seen macroscopically by FA before and after foreign body removal.