West African crystalline maculopathy.
OBJECTIVE
To report new observations in West African crystalline maculopathy.


METHODS
Retrospective, observational case series.


METHODS
Three patients drawn from a private retina practice.


METHODS
Review of clinical charts and photographic studies.


METHODS
Distribution of intraretinal crystals and changes after laser photocoagulation, and history of ingesting foods typical in a West African diet but atypical for an American diet.


RESULTS
All patients were older than 50 years, had diabetic retinopathy, ate green vegetables not found in American diets, and showed no deleterious effects of the crystals. Kola nut ingestion in 2 patients was remote and sparse, and was unknown in a third patient. The first 2 affected patients originating outside the Ibo tribe of Nigeria are reported. The pattern of retinal crystals can be changed, and the quantity of crystals reduced, by laser photocoagulation of associated diabetic retinopathy.


CONCLUSIONS
West African crystalline retinopathy is distinguishable from other causes of crystalline retinopathy. It may reflect a component of the West African diet, seems to have diabetic retinopathy as a promoting factor via breakdown of the blood-retina barrier, and can be modified by laser photocoagulation of diabetic retinopathy. Increased awareness of the condition will allow physicians seeing West African immigrants to make the diagnosis and treat the patients appropriately.
Browning
David J
DJ
Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, North Carolina, USA. dbrowning@ceenta.com
D000368:Aged; D001813:Blood-Retinal Barrier; D003460:Crystallization; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000601:surgery; D004032:Diet; D004641:Emigration and Immigration; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017075:Laser Coagulation; D007988:Liberia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000208:ethnology; D009657:North Carolina / Q000453:epidemiology; D012164:Retinal Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000601:surgery; D012189:Retrospective Studies