Indian Journal of Ophthalmology - Case Reports

PHOTO ESSAY
Year
: 2022  |  Volume : 2  |  Issue : 3  |  Page : 810--811

A fully-bloomed rosette: An atypical presentation


Prateek Jain, Akanksha Kumari, Anshuman Pattnaik 
 Department of Community Ophthalmology, Global Hospital Institute of Ophthalmology, Sirohi, Rajasthan, India

Correspondence Address:
Dr. Prateek Jain
Global Hospital Institute of Ophthalmology, Abu Road, Sirohi, Rajasthan - 307 510
India

Abstract




How to cite this article:
Jain P, Kumari A, Pattnaik A. A fully-bloomed rosette: An atypical presentation.Indian J Ophthalmol Case Rep 2022;2:810-811


How to cite this URL:
Jain P, Kumari A, Pattnaik A. A fully-bloomed rosette: An atypical presentation. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Dec 3 ];2:810-811
Available from: https://www.ijoreports.in/text.asp?2022/2/3/810/351190


Full Text



A 45-year-old male presented with complaints of reduced vision in both eyes (BE) for the past one year. Visual acuity was 6/18 improving to 6/9 in right eye (RE) and 6/60 improving to 6/24 in left eye (LE) respectively. Slit-lamp examination of BE showed presence of central posterior sub-capsular cataract (PSC). In addition, LE showed radiating-feathery lenticular opacities resembling flower petals along with presence of central disc of PSC resembling flower pistil. A distinct transparent zone around the PSC delineating it from the surrounding rosette can be appreciated [Figure 1].{Figure 1}

The patient didn't reveal any history of ocular trauma or drug abuse. There was no history of any systemic illness, metabolic disease, family history or previous ocular surgery. Intraocular pressure, gonioscopy and fundoscopy were unremarkable in BE. The patient underwent cataract surgery in LE with implantation of posterior chamber intraocular lens and had satisfactory visual outcome.

 Discussion



Rosette-shaptxed lenticular opacification is usually seen in patients with blunt trauma, diabetes, lightning injury, exposure to infrared or ionizing radiations.[1] The typical rosette shape is acquired due to the dysfunctional lens epithelium causing edema of the posterior cortical lens fibers and creating a lamellar zone of vacuolation.[2] This vacuolation zone delineates the cortical sutures in the shape of a star along the architectural pattern of the lens, hence producing radiating feathery lines resembling flower petals [Figure 2].[3]{Figure 2}

Rosette cataract can occasionally regress after good glycemic control in diabetics. Similarly, trauma, Nd: Yag iridotomy or vitrectomy–induced rosette cataract can also undergo spontaneous remission.[4],[5]

Our case is noteworthy because a fully-developed rosette cataract surrounding the pre-existing central PSC with a delineating transparent zone having negative history of ocular trauma or systemic illness has never been reported in the literature.

Acknowledgements

The authors acknowledge the guidance of Dr V C Bhatnagar, Head of Department and Medical Superintendent, Global Hospital Institute of Ophthalmology.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Singh RB, Thakur S, Ichhpujani P. Traumatic rosette cataract. BMJ Case Rep 2018;11:e227465.
2Asano N, Schlötzer-Schrehardt U, Dörfler S, Naumann GO. Ultrastructure of contusion cataract. Arch Ophthalmol 1995;113:210-5.
3Gajiwala U. Traumatic cataract, retroillumination. Atlas Ophthalmol Online Journal of Ophthalmology Available from: https://www.atlasophthalmology.net/photo.jsf; jsessionid=4C2912C763976CA60E9D940BF288680B?node=7216&locale=pt. [Last accessed on 2022 Feb 09].
4Elmajri KA. Spontaneous resolution of a traumatic cataract in cerebral palsy Libyan patient. Biomed J Sci Tech Res Biomed Res Netw 2021;37:29334-7.
5Wollensak G, Eberwein P, Funk J. Perforation rosette of the lens after Nd: YAG laser iridotomy. Am J Ophthalmol 1997;123:555-7.