Response to: A case report on allopurinol induced crystalline maculopathy
Bibliographic record
Abstract
Dear Editor, We read with interest the article by Cheah et al1 reporting a case of allopurinol-induced crystalline maculopathy in a 33-year-old female patient. Crystalline maculopathy is a rare condition, with a variety of possible causes.2, 3 Although allopurinol is a commonly used medication, the Cheah paper would represent the first and only case in the peer-reviewed literature of crystalline maculopathy secondary to its use. The authors reference two remote reports of association between allopurinol use and macular degeneration.4, 5 However, it is important to note that there have been no further publications within the ophthalmic literature since the 1960s supporting such an association despite allopurinol being a very commonly prescribed medication. The authors present color fundus photographs of both eyes that show small yellowish lesions in the macula. The lesions are focused temporally in the macula and do not appear to be prominent in the nasal macula. In the optical coherence tomography (OCT) images, the authors highlight small hyper-reflective lesions in the nasal retina and identify these as crystals. However, as mentioned, on the color photographs, the small yellowish lesions are not present in the nasal macula. In fact, we believe the authors have highlighted normal blood vessels, and have interpreted these as crystals. It is interesting to note that although the lesions are readily visualized on the color photographs and near-infrared images provided, there are no obvious changes on OCT that can be correlated. We believe the case presented by Cheah et al in fact represents a recently described condition called “benign yellow dot maculopathy”6 and not a crystalline retinopathy.7-9
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".