title: Yellow corneal ring associated with vitamin supplementation for age-related macular degeneration.
abstract: OBJECTIVE
  To report the first described cases of peripheral yellow corneal rings secondary to vitamin supplementation for age-related macular degeneration (ARMD).
  
  
  METHODS
  Retrospective single-center case series.
  
  
  METHODS
  The eyes of 4 patients taking vitamin supplementation for ARMD were examined at the University of Pittsburgh Medical Center Department of Ophthalmology between January 2010 and April 2011.
  
  
  METHODS
  We reviewed the medical records of 4 patients with peripheral corneal rings receiving vitamin supplementation for ARMD.
  
  
  METHODS
  The presence of peripheral yellow corneal rings, skin findings, and serum carotene levels.
  
  
  RESULTS
  Each patient had circumferential, yellow, peripheral corneal rings and exhibited subtle yellowing of the skin most notable on the palms. Serum carotene levels were normal in 2 of the 3 patients and markedly elevated in the last patient in whom it was measured.
  
  
  CONCLUSIONS
  It is unclear at this time how to counsel patients with this ocular finding. We suspect that these rings are more common than generally appreciated because they may have a subtle appearance or be misdiagnosed as arcus senilis. We suggest that a formal study be performed on a cohort of patients taking vitamin supplementation for macular degeneration that specifically screens for yellow rings and measures serum carotene levels when they are identified.
authors.affiliation: Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. elleraw@upmc.edu
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Eller
authors.forename: Ian R
authors.initials: IR
authors.lastname: Gorovoy
authors.forename: Vera A
authors.initials: VA
authors.lastname: Mayercik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D003316:Corneal Diseases / Q000139:chemically induced*; D003319:Corneal Stroma / Q000737:chemistry / Q000187:drug effects* / Q000473:pathology; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D016850:Limbus Corneae / Q000737:chemistry / Q000187:drug effects* / Q000473:pathology; D008268:Macular Degeneration / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014815:Vitamins / Q000009:adverse effects* / Q000097:blood / Q000737:chemistry; D019207:beta Carotene / Q000009:adverse effects* / Q000097:blood / Q000737:chemistry
chemical_list: D014815:Vitamins; D019207:beta Carotene