Ophthalmological Manifestations of Alkaptonuria

Abstract

Alkaptonuria is rare autosomal recessive multisystem disease, caused by mutations in the homogentisine oxidase gene, which leads to the deposition of metabolites of homogentisic acid in organs and tissues (ochronosis).The purpose: to study spectrum of ophthalmic manifestations of alkaptonuria in Russian cohort of patients of different ages.Material and methods. Ophthalmological examination of 9 patients: 5 adults aged from 39 to 64 years and 4 children aged from 3 to 6 years with confirmed diagnosis of “alkaptonuria” was performed.Results. In all adult patients bilateral brown-black scleral pigmentation and yellow-brown deposits in the conjunctiva in the region of the palpebral fissure were detected paralymbally, the severity of which correlated with age, tortuosity and vasodilation of the conjunctiva in areas of deposits. In 1 out of 4 children minimal deposits of yellow pigment were found in the conjunctiva of the limb. In patients older than 60 years typical small brownish deposits were observed in the cornea near the limb in the region of the palpebral fissure.Conclusion. Eye changes are one of the most common clinical manifestations of alkaptonuria. Typical manifestations are the sclera’s pigmentation, conjunctiva and cornea in the limb. Ophthalmological examination is non-invasive informative method that can help in early diagnosis, differential diagnostics, assessment of the dynamics of the disease and the effectiveness of the therapy.