title: Arginine-Restricted Therapy Resistant Bilateral Macular Edema Associated with Gyrate Atrophy.
abstract: Introduction. Gyrate atrophy is a rare genetical metabolic disorder affecting vision. Here, we report a 9-year-old boy with gyrate atrophy associated with bilateral macular edema at the time of diagnosis and the effect of long term metabolic control on macular edema. Case Presentation. A 9-year-old boy presented with a complaint of low visual acuity (best corrected visual acuity: 20/80 in both eyes, refractive error: -12.00 D). Dilated fundus examination revealed multiple bilateral, sharply defined, and scalloped chorioretinal atrophy areas in the midperipheral and peripheral zone. Spectral-domain optical coherence tomography revealed bilateral cystoid macular edema in both eyes. Serum ornithine level was high (622 μmol/L). An arginine-restricted diet reduced serum ornithine level (55 μmol/L). However, visual findings including macular edema remained unchanged in 2 years of follow-up. Conclusion. Arginine-restricted diet did not improve macular edema in our patient with gyrate atrophy. A more comprehensive understanding of the underlying factors for macular edema will lead to the development of effective therapies.
authors.affiliation: Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, 06240 Ankara, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Doguizi
authors.affiliation: Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, 06240 Ankara, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Sekeroglu
authors.affiliation: Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, 06240 Ankara, Turkey.
authors.forename: Mustafa Alpaslan
authors.initials: MA
authors.lastname: Anayol
authors.affiliation: Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, 06240 Ankara, Turkey.
authors.forename: Pelin
authors.initials: P
authors.lastname: Yilmazbas