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| PHOTO ESSAY |
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| Year : 2022 | Volume
: 2
| Issue : 3 | Page : 810-811 |
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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
| Date of Submission | 11-Feb-2022 |
| Date of Acceptance | 18-Apr-2022 |
| Date of Web Publication | 16-Jul-2022 |
Correspondence Address:
Dr. Prateek Jain
Global Hospital Institute of Ophthalmology, Abu Road, Sirohi, Rajasthan - 307 510
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijo.IJO_418_22
Keywords: Combined cataract, PSC, rosette cataract
How to cite this article:
Jain P, Kumari A, Pattnaik A. A fully-bloomed rosette: An atypical presentation. Indian J Ophthalmol Case Rep 2022;2:810-1 |
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: Slit-lamp image in retro-illumination: (a) presence of central PSC with surrounding clear lens in RE; (b) presence of central PSC surrounded by radiating feathery lenticular opacities with delineating transparent zone separating them in LE
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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: Slit-lamp image of LE in retro-illumination: (a) image showing floral pattern with petaloid posterior lenticular opacities, (b) image under 40× magnification showing cellular hydration of lens fibers with vacuolation along the course of lenticular fibers
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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 | | |
| 1. | Singh RB, Thakur S, Ichhpujani P. Traumatic rosette cataract. BMJ Case Rep 2018;11:e227465.  |
| 2. | Asano N, Schlötzer-Schrehardt U, Dörfler S, Naumann GO. Ultrastructure of contusion cataract. Arch Ophthalmol 1995;113:210-5. |
| 3. | |
| 4. | Elmajri KA. Spontaneous resolution of a traumatic cataract in cerebral palsy Libyan patient. Biomed J Sci Tech Res Biomed Res Netw 2021;37:29334-7. |
| 5. | Wollensak G, Eberwein P, Funk J. Perforation rosette of the lens after Nd: YAG laser iridotomy. Am J Ophthalmol 1997;123:555-7. |
[Figure 1], [Figure 2]
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