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CASE REPORT
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 739-743

Optic neuropathy and retinopathy due to advanced cobalt toxicity


1 Division of Ophthalmology, Department of Surgery, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington; Department of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
2 Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, United States
3 Division of Ophthalmology, Department of Surgery, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington; Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, United States

Correspondence Address:
Dr. Geetha K Athappilly
Lahey Medical Center, 1 Essex Center Drive, Peabody, MA - 01960
United States
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3047_21

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We report a rare case of cobalt toxicity resulting in a combined optic neuropathy and retinopathy. A 58-year-old woman with a recent revision of a hip implant presented with profound loss of vision. Although her initial exam was structurally unremarkable, she developed progressive outer retinal atrophy and optic nerve pallor. Abnormalities were also demonstrated in the full-field electroretinogram and optic nerve sheath on magnetic resonance imaging (MRI). Cobalt levels in the serum were severely elevated (734 μg/L) from the dysfunctional metal-on-metal (MoM) hip implant. Removal of the implant led to a rapid reduction in cobalt levels and stabilization of her declining vision.


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