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

Effects of Metal Ions and Substituents on HOMO-LUMO Gap Evident from UV-Visible and Fluorescence Spectra of Anthracene Derivatives

Controlled intake of complex metal cations and anions in the human body and other biological systems is essential for the health and well-being of the environment. Anthracene and anthracene derivatives are the most widely used sensors for this purpose. Because of their convenience, better detection and results are preferred over colorimetric sensors, which offer better color detection by the naked eye. This review article will present different designs of chemosensors using fluorescence and UV-visible spectroscopy to determine different ions. Density functional theory and Austin model 1 are widely used for theoretical and computational studies of the energy levels of molecules. The Indo/Cis method is used to calculate the geometries of anthracene oligomers. A novel anthracene-based fluorescent probe containing the benzothiazole group BFA was highly sensitive and selective toward trivalent cations (Cr3+ and Fe3+). This sensor is not sensitive to other ions, including Aluminum trivalent ions. (N- ((anthracen-9-yl) methyl)-N-(pyridin-2-yl) pyridin-2-amine) has been designed to detect zinc and copper. Click chemistry using photodimerization can be used to form cellulose nanoparticles. TEMPO-mediated hypohalite oxidation converts hydroxyl groups to carboxylic groups. Amide linkage formation between amine and carboxylic acid was followed by the installation of an alkyne group. Copper (I)-catalyzed Azide-Alkyne Cycloaddition (CuAAC) was used to produce highly photoresponsive and fluorescent cellulose nanoparticles by using coumarin, anthracene, and generated nanomaterials. The effects of naphthalene and phenanthrene on the spectra of anthracene were determined in a dilute solution. Temperature and solvent effects introduce different changes in fluorescence, emission, and absorption bands, leading to some changes in the configuration of anthracene. The solvent and temperature effects on variations of emission maxima of exciplex anthracene-diethylaniline (DEA) are also discussed.

Subconjunctival Ocular Argyrosis following Treatment with Ruthenium 106 Brachytherapy for Choroidal Melanoma

Introduction

Ruthenium-106 (Ru-106) brachytherapy is one of the commonest eye-sparing treatments for choroidal melanoma. These patients require long-term surveillance of the treated tumour remnant to ensure there is no local recurrence. New or progressive pigmented lesions in treated eyes are often regarded as suspicious - especially if there are concerns of extra-scleral extension.

Case Presentations

We present two cases of posterior choroidal melanoma treated five and 10 years previously with Ru-106. Both cases developed subconjunctival dark/black lesions on the anterior surface of the eye in the quadrant of the conjunctival peritomy during Ru-106 treatment. Both had similar findings on histopathology: black, non-organic, particulate foreign material of varying confluence deposited on elastin and collagen fibres. Energy dispersive X-ray microanalysis confirmed the material contained silver.

Discussion

The Ru-106 applicator consists of a radioactive core of Ru-106 encapsulated within pure silver as a radiation shield. During surgical insertion, stainless steel suture needles and forceps can occasionally scratch the applicator's silver eyelets and scatter microscopic particles of elemental silver into the operative field. These particles were likely deposited within the subconjunctival tissues of these patients during brachytherapy administration, leading to localised ocular argyrosis. Iatrogenic ocular argyrosis should be considered in the differential diagnosis of new pigmented lesions in patients treated with Ru-106 brachytherapy. This study is the first to unequivocally identify the cause of some post-brachytherapy ocular surface pigmentation as caused by silver.

Multimodal ocular imaging in diagnosis and management of occupational ocular argyrosis

Occupational ocular argyrosis is a rare disorder associated with accumulation of silver in the eye due to its occupational exposure. A 39-year-old male patient, a silver utensils polisher for the past 30 years, presented with bilateral gradual diminution of vision (presently 20/200) for 2 years. His serum silver levels were raised and ocular examination revealed bilateral greenish brown corneal deposits and complicated cataract. Anterior segment optical coherence tomography (OCT) and confocal microscopy suggested deposition of silver in various corneal layers. Multifocal electroretinogram showed a generalized decrease in sensitivity of P1 waves. Increased internal aberrations on aberrometric profile favoured phacoemulsification followed by intraocular lens implantation in both eyes. Postoperatively, the visual gain of 20/20 and normal fundus picture on indirect ophthalmoscopy, macular OCT, and fundus autofluorescence favored good prognosis in both eyes.

Clinical and Forensic Aspects of the Different Subtypes of Argyria

Argyria encompasses the different cosmetic alterations that can develop if enough silver particles deposit in a specific tissue, typically in the skin, ranging from localized dark-blue macules to a generalized slate-gray/bluish tinge following systemic absorption. This work aims to fully review the state of the art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic features of argyria. Argyria has been diagnosed in a wide range of ages, both sexes and varied ethnicities, with no known individual predisposing factors. Ultraviolet radiation with subsequence increases of melanin production aggravates the discoloration due to a reduction in the silver deposits. Physical examination and silver exposure in the anamnesis can be highly suggestive of the diagnosis, but a histopathological analysis with Energy-Dispersive X-ray Spectroscopy is required to unequivocally determine the discoloration etiology. Safe and effective treatment has only been accomplished with laser techniques, though only a few cases have been reported and with limited follow-up time. In conclusion, argyria typically has an occupational or iatrogenic etiology. It should be suspected when a patient presents with typical skin or eye lesions. A seemingly viable treatment modality, with laser technology, is finally within the horizon.

[Bluish-gray discoloration of skin and conjunctiva]

Colloidal silver used as a suspension for (alternative) therapeutic purposes or silver exposure due to environmental or working conditions can lead to irreversible deposits of silver granules in the skin (bluish-gray hue of the skin), mucosa, cornea, retina and internal organs. Silver-induced discoloration of the conjunctiva should therefore be taken into account when a bluish-gray discoloration raises the suspicion of conjunctival melanoma.

Ocular Argyrosis Mimicking Conjunctival Melanoma

PURPOSE

To present a novel case of ocular argyrosis mimicking conjunctival melanoma.

METHODS

A 48-year-old man who is a jewelry manufacturer presented with raised pigmented lesions in the inferior fornices of both eyes. Brown-black colored, follicle-like, masses were observed in both fornices.

RESULTS

An incisional biopsy confirmed the presence of silver and the diagnosis of ocular argyrosis.

CONCLUSIONS

Despite its limited negative health effects, ocular argyrosis should be considered in the differential diagnosis of conjunctival pigmented lesions because of the potential for misidentification of neoplastic growth.

Diagnostic methods in ocular argyrosis: case report

Purpose

The aim of this report is to present a case of a patient, metal foundry worker, who had been exposed to industrial silver salts for over 20 years. It is well established that chronic exposure to silver compounds can cause accumulation of silver deposits in various tissues. This condition is referred to as argyrosis or argyria, whereas changes related to eye tissues are defined as ocular argyrosis.

Methods

A complete eye examination, corneal confocal microscopy, kinetic and static visual field test, posterior segment optical coherent tomography, pattern visual evoked potentials (PVEP), flash visual evoked potentials, multifocal electroretinogram, pattern electroretinogram (PERG), full-field electroretinography (FERG) and electrooculogram were all performed.

Results

Eye examination revealed decreased visual acuity, corneal deposits and drusenoid changes within the macula. Although electrophysiology tests did not show changes in the function of retinal pigment epithelium, they revealed abnormal function of photoreceptors in the central and peripheral retina. PERG abnormalities and delayed latency of P100 wave in PVEP confirmed impaired function of the inner layers of the retina in the macular region.

Conclusions

Corneal confocal microscopy and electrophysiological tests may help confirm the diagnosis of ocular argyrosis.