Evidence map›Paper›PMID 40678736›Full record

ArticleAmerican journal of ophthalmology case reports2025

Cobalt-induced Retinopathy: Unveiling the hidden risk of knee prosthesis.

Aim-On Saengsirinavin, Jia-Horung Hung, Anadi Khatri, Celine Dan-Tam Nguyen, Pamok Seangsirinavin, Frances Andrea Anover, Negin Yavari, Dalia El-Feky, Ngoc Trong Tuong Than, Osama Elaraby and 8 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of ophthalmology case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Aim-On SaengsirinavinByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Jia-Horung HungByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Anadi KhatriByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Celine Dan-Tam NguyenByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Pamok SeangsirinavinDepartment of Orthopedics, Police General Hospital, Bangkok, Thailand.
Frances Andrea AnoverByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Negin YavariByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Dalia El-FekyByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Ngoc Trong Tuong ThanByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Osama ElarabyByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Xiaoyan ZhangByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Anh Ngoc Tram TranByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Cigdem YasarByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Azadeh MobasserianByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Irmak KaracaByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Amir AkhavanrezayatByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Chi Mong Christopher OrByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Quan Dong NguyenByers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To report a case of cobalt-induced retinopathy from a knee prosthesis and to outline the diagnostic challenges and management approach. Observation: A 67-year-old female presented with chronic bilateral visual disturbances, including blurred vision and photopsia, which began shortly after receiving a cobalt-containing knee prosthesis (DePuy Sigma Total Knee System, recalled by FDA in 2014, Recall No. Z-0423-2014). Ophthalmic evaluation revealed bilateral chorioretinitis, cystoid macular edema, and optic disc inflammation. Removal of the cobalt-containing prosthesis, along with aggressive immunosuppressive therapy, led to significant improvement in visual acuity and retinal function, as confirmed by fluorescein angiography, electroretinography, and Goldmann visual field testing. Conclusion: This case adds to the limited literature on cobalt-induced retinopathy by demonstrating that even small prosthetic implants, such as knee prostheses, can lead to systemic cobalt toxicity with significant ocular complications. Early diagnosis, combined with prompt removal of the affected prosthesis and management of inflammation, is crucial for restoring vision and preventing further damage.

Identifiers

PMID40678736
PMCPMC12270631

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.