Bilateral retinal detachment – when the kidney meets the eye
ABSTRACT Exudative retinal detachment occurs when fluid accumulates between the neurosensory retina and the retinal pigment epithelium. Ocular diseases or multisystem conditions such as nephrotic syndrome may lead to exudative retinal detachment. This report describes a case of nephrotic syndrome se...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Oftalmologia
2021-11-01
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| Series: | Revista Brasileira de Oftalmologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802021000500507&tlng=en |
| _version_ | 1798019432263450624 |
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| author | Susana Henriques Anna Lima Júlio Almeida Rita Basto Joana Roque Inês Coutinho Isabel Prieto |
| author_facet | Susana Henriques Anna Lima Júlio Almeida Rita Basto Joana Roque Inês Coutinho Isabel Prieto |
| author_sort | Susana Henriques |
| collection | DOAJ |
| description | ABSTRACT Exudative retinal detachment occurs when fluid accumulates between the neurosensory retina and the retinal pigment epithelium. Ocular diseases or multisystem conditions such as nephrotic syndrome may lead to exudative retinal detachment. This report describes a case of nephrotic syndrome secondary to minimal change disease, anasarca and bilateral serous macular detachment in an adult patient. A 75-year-old male patient presented to the emergency department with generalized edema, asthenia, and visual impairment. Medical history included a recent diagnosis of nephrotic syndrome secondary to minimal change disease, which had been controlled with corticosteroid therapy. At presentation, best corrected visual acuity was 20/100. Slit-lamp examination revealed xanthelasmas and mild bilateral eyelid edema and chemosis. Dilated fundus examination confirmed bilateral macular detachment. The patient did not respond to diuretic therapy. Ttherefore, hemodialysis was started. Two months later, visual acuity improved to 20/25 and near normal restoration of retinal anatomy was achieved, with concurrent remission of proteinuria. Exudative retinal detachment is a multifactorial condition. However, in diseases associated with severe hypoalbuminemia, such as nephrotic syndrome, low oncotic pressure in choroidal vessels and high interstitial pressure in the choroid may explain retinal detachment. Patients with chronic kidney disease carry a high risk of ophthalmic disease development. Several mechanisms that affect ocular vessels, the retina and the choroid are thought to be involved. A multidisciplinary approach is crucial to resolve the ophthalmic condition and improve overall health. |
| first_indexed | 2024-04-11T16:40:32Z |
| format | Article |
| id | doaj.art-53aae78f94e841b5ac1346cb321c0058 |
| institution | Directory Open Access Journal |
| issn | 1982-8551 |
| language | English |
| last_indexed | 2024-04-11T16:40:32Z |
| publishDate | 2021-11-01 |
| publisher | Sociedade Brasileira de Oftalmologia |
| record_format | Article |
| series | Revista Brasileira de Oftalmologia |
| spelling | doaj.art-53aae78f94e841b5ac1346cb321c00582022-12-22T04:13:41ZengSociedade Brasileira de OftalmologiaRevista Brasileira de Oftalmologia1982-85512021-11-0180510.37039/1982.8551.20210045Bilateral retinal detachment – when the kidney meets the eyeSusana Henriqueshttps://orcid.org/0000-0003-2786-3570Anna Limahttps://orcid.org/0000-0002-3937-7433Júlio Almeidahttps://orcid.org/0000-0002-4651-8812Rita Bastohttps://orcid.org/0000-0001-8503-8574Joana Roquehttps://orcid.org/0000-0002-0713-7064Inês Coutinhohttps://orcid.org/0000-0002-0536-7472Isabel Prietohttps://orcid.org/0000-0001-7094-817XABSTRACT Exudative retinal detachment occurs when fluid accumulates between the neurosensory retina and the retinal pigment epithelium. Ocular diseases or multisystem conditions such as nephrotic syndrome may lead to exudative retinal detachment. This report describes a case of nephrotic syndrome secondary to minimal change disease, anasarca and bilateral serous macular detachment in an adult patient. A 75-year-old male patient presented to the emergency department with generalized edema, asthenia, and visual impairment. Medical history included a recent diagnosis of nephrotic syndrome secondary to minimal change disease, which had been controlled with corticosteroid therapy. At presentation, best corrected visual acuity was 20/100. Slit-lamp examination revealed xanthelasmas and mild bilateral eyelid edema and chemosis. Dilated fundus examination confirmed bilateral macular detachment. The patient did not respond to diuretic therapy. Ttherefore, hemodialysis was started. Two months later, visual acuity improved to 20/25 and near normal restoration of retinal anatomy was achieved, with concurrent remission of proteinuria. Exudative retinal detachment is a multifactorial condition. However, in diseases associated with severe hypoalbuminemia, such as nephrotic syndrome, low oncotic pressure in choroidal vessels and high interstitial pressure in the choroid may explain retinal detachment. Patients with chronic kidney disease carry a high risk of ophthalmic disease development. Several mechanisms that affect ocular vessels, the retina and the choroid are thought to be involved. A multidisciplinary approach is crucial to resolve the ophthalmic condition and improve overall health.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802021000500507&tlng=enRetinal detachmentNephrotic syndromeRenal insufficiency, chronic |
| spellingShingle | Susana Henriques Anna Lima Júlio Almeida Rita Basto Joana Roque Inês Coutinho Isabel Prieto Bilateral retinal detachment – when the kidney meets the eye Revista Brasileira de Oftalmologia Retinal detachment Nephrotic syndrome Renal insufficiency, chronic |
| title | Bilateral retinal detachment – when the kidney meets the eye |
| title_full | Bilateral retinal detachment – when the kidney meets the eye |
| title_fullStr | Bilateral retinal detachment – when the kidney meets the eye |
| title_full_unstemmed | Bilateral retinal detachment – when the kidney meets the eye |
| title_short | Bilateral retinal detachment – when the kidney meets the eye |
| title_sort | bilateral retinal detachment when the kidney meets the eye |
| topic | Retinal detachment Nephrotic syndrome Renal insufficiency, chronic |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802021000500507&tlng=en |
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