title: The sunflower cataract in Wilson's disease: pathognomonic sign or rare finding?
abstract: The presence of Kayser-Fleischer ring in patients with Wilson's disease (WD) is well documented and included in diagnostic algorithms; however, data about the occurrence of the second postulated ophthalmological sign of WD, sunflower cataract (SC), are limited and even conflicting. The aim of our study was to verify the occurrence of SC in WD. From January 2010 to May 2015, 81 consecutive, newly diagnosed WD patients underwent detailed ophthalmological examinations, including slit lamp examination with special attention to lens transparency, to verify the presence of SC in WD-naive patients. SC was detected in only one (1.2 %) of the examined WD patients, did not impact visual acuity; moreover, completely disappeared following a year of treatment for WD. SC may be a very rare and reversible ophthalmological manifestation of WD that is observed seldom and only at the time of WD diagnosis. We postulate that a finding of SC in WD patients is an interesting finding that may occur in the course of WD, but it is not a pathognomonic sign of WD.
authors.affiliation: Second Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9, 02 957, Warsaw, Poland.|Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Langwińska-Wośko
authors.affiliation: Second Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9, 02 957, Warsaw, Poland. tomlit@medprakt.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Litwin
authors.affiliation: Second Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9, 02 957, Warsaw, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Dzieżyc
authors.affiliation: Second Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9, 02 957, Warsaw, Poland.|Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Członkowska
mesh_terms: D000293:Adolescent; D000328:Adult; D002386:Cataract / Q000150:complications / Q000175:diagnosis*; D003300:Copper / Q000378:metabolism*; D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006527:Hepatolenticular Degeneration / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D003300:Copper
keywords: Kayser–Fleischer ring; Lens; Sunflower cataract; Wilson’s disease