Case Report Introspection: A Curious Case of Lens Luxation ¨ Roland Backhaus, MD, Gerhard Schuierer, MD, Christoph Rohrer, MD, M. Andreea Gamulescu, MD, Horst Helbig, MD, Ulrich Bogdahn, MD, Felix Schlachetzki, MD From the Department of Neurology, University of Regensburg, Bezirksklinikum, Regensburg, Germany (RB, UB, FS); Center for Neuroradiology, Regensburg University, Bezirksklinikum, Regensburg, Germany (GS, CR); and Department of Ophthalmology, Regensburg University Medical Center, Regensburg, Germany (MAG, HH).
Keywords: Sonography, luxation lens, MRI. Acceptance: Received February 10, 2014, and in revised form May 14, 2014. Accepted for publication June 1, 2014. Correspondence: Address correspondence to Roland Backhaus, MD, Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Universitatsstrasse 84, 93051 Regensburg, Germany. E-mail: [email protected]. ¨ J Neuroimaging 2015;25:513. DOI: 10.1111/jon.12161
Incidental magnetic resonance imaging finding of a luxated lens in a 76-year-old patient’s work up for transient ischemic attack (Fig 1). Further history revealed sudden loss of vision in the right eye to movement perception after surgery for abdominal aortic aneurysm 6 months ago. Lens luxation is a common complication in Marfan’s syndrome,1 connective tissue abnormalities, trauma—and even more so in Terrier breeds.2 The dark appearance of the lens in T2 turbo-spin-echo is related to the protein concentration of the lens and the proton binding to the lens protein. Orbital sonography was performed (Fig 2) with a linear transducer positioned on the upper lid of the closed eye.3 The lens floats freely in the vitreous body according to its position of the head. Lens replacement would be the therapy of choice.
Fig 2. (A) Ocular B-mode sonography showing concentric layers due to increased reflectivity. Posterior position of the lens in supine position. (B) Basal position of the lens in upright position in contrast to (A) indicating free movement of the lens in the vitreous body.
References
Fig 1. T2tse demonstrating right posterior lens luxation in supine position. TR 4670 ms, TE 84 ms, ETL 7, SD 3 mm, Gap 0 mm.
Copyright
1. Dureau P. Pathophysiology of zonular diseases. Curr Opin Ophthalmol 2008;19(1):27-30. 2. Gelatt Kirk N. (ed.). Veterinary Ophthalmology. 3rd ed. Lippincott, Williams & Wilkins, 1999. 3. Ertl M, Barinka F, Torka E, et al. Ocular color-coded sonography - A promising tool for neurologists and intensive care physicians. Ultraschall Med 2014 Mar 19. [Epub ahead of print]
◦ 2014 by the American Society of Neuroimaging C
513
Copyright of Journal of Neuroimaging is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Keywords: Sonography, luxation lens, MRI. Acceptance: Received February 10, 2014, and in revised form May 14, 2014. Accepted for publication June 1, 2014. Correspondence: Address correspondence to Roland Backhaus, MD, Department of Neurology, University of Regensburg, Bezirksklinikum Regensburg, Universitatsstrasse 84, 93051 Regensburg, Germany. E-mail: [email protected]. ¨ J Neuroimaging 2015;25:513. DOI: 10.1111/jon.12161
Incidental magnetic resonance imaging finding of a luxated lens in a 76-year-old patient’s work up for transient ischemic attack (Fig 1). Further history revealed sudden loss of vision in the right eye to movement perception after surgery for abdominal aortic aneurysm 6 months ago. Lens luxation is a common complication in Marfan’s syndrome,1 connective tissue abnormalities, trauma—and even more so in Terrier breeds.2 The dark appearance of the lens in T2 turbo-spin-echo is related to the protein concentration of the lens and the proton binding to the lens protein. Orbital sonography was performed (Fig 2) with a linear transducer positioned on the upper lid of the closed eye.3 The lens floats freely in the vitreous body according to its position of the head. Lens replacement would be the therapy of choice.
Fig 2. (A) Ocular B-mode sonography showing concentric layers due to increased reflectivity. Posterior position of the lens in supine position. (B) Basal position of the lens in upright position in contrast to (A) indicating free movement of the lens in the vitreous body.
References
Fig 1. T2tse demonstrating right posterior lens luxation in supine position. TR 4670 ms, TE 84 ms, ETL 7, SD 3 mm, Gap 0 mm.
Copyright
1. Dureau P. Pathophysiology of zonular diseases. Curr Opin Ophthalmol 2008;19(1):27-30. 2. Gelatt Kirk N. (ed.). Veterinary Ophthalmology. 3rd ed. Lippincott, Williams & Wilkins, 1999. 3. Ertl M, Barinka F, Torka E, et al. Ocular color-coded sonography - A promising tool for neurologists and intensive care physicians. Ultraschall Med 2014 Mar 19. [Epub ahead of print]
◦ 2014 by the American Society of Neuroimaging C
513
Copyright of Journal of Neuroimaging is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
