Retina-Vitreous
2009 , Vol 17 , Num 3
From Fundus Examination to Systemic Disorder: Familial Adenomatous Polyposis (Fap)
1Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi 1. Göz Kliniği, İstanbul, Doç. Dr.2Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi 1. Göz Kliniği, İstanbul, Asist. Dr.
3Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi 1. Göz Kliniği, İstanbul, Prof. Dr. A 23 year old woman was admitted to Dr. Lutfi Kirdar Kartal Training and Research Hospital 1.st Eye Clinic at April 2007 because of decreasing in visual acuity in her both eyes. The uncorrected visual acuity was 0.7 and corrected visual acuity was 1.0 in both eyes.
During the patient’s visual consultation, it was realized that theuncorrected visual acuity was 0.7 and corrected visual acuity was 1.0 in both eyes. The routine biomicroscopic evaluation revealed that anterior segment was normal but fundus examination pounted out that pigmented, well demarcated, oval lesions like pigment epithelium hypertrophy in both periphery of the retina. As it was tought that this lesions may associate with sistemic disorders, the patient was interrogated. It was learned that she had diarrhea and stomach ache for 6 months but it was unidentified. Owing to this reason the patient was consultated with internal medicine. When colonoscopy was performed, multipl polyps in the colon were demonstrated. The biopsy was taken and adenocarsinoma developed from the basement of polyposis coli was documented. Liver metastasis was identified with computarized tomography. The patients was thought to be familial adenomatous polyposis and family cross-hatching was made. Both of two brothers were diagnosed with polyposis coli and fundus examination showed the same pigmented oval lesions. The total colectomy was performed to all of the tree patients who were followed by general surgery.
During the routine ophthalmologic examination, even if the visual acuity of the patient is good, the ophthalmologic examination is being made carefully, in fact the findings seeming to be not important may be helpful for early identification of serious ophthalmologic or systemic diseases. Keywords : Familial adenomatous polyposis, pigment epithelium hypertrophy, adenocarsinoma