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Images in clinical medicine

“Stars on a clear night”

“Stars on a clear night”

Narjisse Taouri1,&, Ouafae Cherkaoui1


1Mohammed V University Souissi, Department A of Ophthalmology, Rabat, Morocco



&Corresponding author
Narjisse Taouri, Mohammed V University Souissi, Department A of Ophthalmology, Rabat, Morocco



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We report a case of a 65-year-old-man, who suffers from high blood pressure, and diabetes, with no history of eye trauma. The patient presented to ophthalmology consultation for a routine eye examination. The biomicroscopic examination after pupillary dilation of the right eye, found a large number of small white spherical opacities in the vitreous. Those refringent bodies were mobile with eye movement, and did not affect the patient´s vision. The B-scan ocular ultrasound examination revealed on the vitreous spherical opacities, which were mobile, and highly echogenic, with flat retina. Considering that these vitreous particles did not affect vision, we decided to survey regularly the patient. In our case of the retained diagnosis was asteroid hyalosis, which is a rare degenerative condition of the vitreous, which is marked by an accumulation of calcium-lipid complexes in collagen fibrils of the vitreous, commonly unilateral, benign and usually asymptomatic. And regarding the therapeutic management, rarely the floating opacities can be a cause of myodesopsia, and usually no treatment is necessary, except if there is decreased vision. The first clinical description of this condition was in 1894 by Benson. And because he noticed that the opacities appears while vitreous examination as “stars on a clear night” he termed the pathology asteroid hyalitis. Previous studies have reported that the prevalence of asteroid hyalosis is about 1.2%. They have reported also that is increasing with age and that asteroid hyalosis can be confused with other vitreous degeneration as synchysis scintillans, and vitreous amyloidosis.



Figure 1: slit lamp photograph of the right eye showing asteroid bodies that appears as stars on a clear night