Date: 07 Jun 2012

Intraocular PAS-positive macrophages simulating Whipple’s disease

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Dear Editor,

Large, PAS-positive histiocytes in the retina and vitreous are a rare finding, but a dramatic hallmark of Whipple’s disease when discovered [1]. It should be appreciated, however, that identical intraocular cells (pseudo-Whipple’s histiocytes) may also exceptionally occur as a response to non-infectious damage to the pigment epithelium and to retinal dissolution.

An 88-year-old woman developed blindness, opaque media, and a painful left eye. She was otherwise in stable health and her medical history included hypertension, treated helicobacter pylori gastric ulcer, nonspecific arthritic hip pain, and chronic obstructive pulmonary disease. She had not experienced any recent weight loss, abdominal pain or gastrointestinal problems. Her ophthalmic history was significant for pseudophakic bullous keratopathy and glaucoma of the right eye, which had decompensated over several years leading to a corneal transplant. Following this surgery, her vision was noted to be as good as 20/50