From Wikipedia, the free encyclopedia
Medical condition
Kayser?Fleischer ring
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A Kayser?Fleischer ring in a 32-year-old patient who had longstanding speech difficulties and
tremor
.
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Specialty
| Ophthalmology
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Kayser?Fleischer rings
(
KF rings
) are dark rings that appear to encircle the
cornea
of the
eye
. They are due to
copper
deposition in the
Descemet's membrane
as a result of particular liver diseases.
[1]
They are named after
German
ophthalmologists
Bernhard Kayser
and
Bruno Fleischer
who first described them in 1902 and 1903.
[2]
[3]
[4]
Initially thought to be due to the accumulation of silver, they were first demonstrated to contain copper in 1934.
[5]
Presentation
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]
The rings, which consist of
copper
deposits where the
cornea
meets the
sclera
, in
Descemet's membrane
, first appear as a crescent at the top of the cornea. Eventually, a second crescent forms below, at the "six o'clock position", and ultimately completely encircles the cornea.
[1]
[6]
Associations
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Copper deposition in peripheral Descemet membrane (Kayser?Fleischer ring) and anterior capsule of crystalline lens ( Sunflower cataract).
Kayser?Fleischer rings are a sign of
Wilson's disease
, which involves abnormal copper handling by the liver resulting in copper accumulation in the body and is characterised by abnormalities of the
basal ganglia
of the
brain
,
liver cirrhosis
,
splenomegaly
, involuntary movements,
muscle rigidity
, psychiatric disturbances,
dystonia
and
dysphagia
. The combination of neurological symptoms, a low blood
ceruloplasmin
level and KF rings is diagnostic of Wilson's disease.
[1]
Other causes of KF rings are
cholestasis
(obstruction of the
bile ducts
),
primary biliary cirrhosis
and "cryptogenic" cirrhosis (cirrhosis in which no cause can be identified).
[1]
Diagnosis
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As Kayser?Fleischer rings do not cause any symptoms, it is common for them to be identified during investigations for other medical conditions. In certain situations, they are actively sought; in that case, the early stages may be detected by
slit lamp
examination before they become visible to the naked eye.
[1]
See also
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References
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External links
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