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Calciphylaxis and bilateral optic neuropathy.

V Huerva1, M C Sánchez, F J Ascaso

  • 1Department of ophthalmology, university hospital Arnau-de-Vilanova, 80, avenida Rovira Roure, 25198 Lleida, Spain. vhuerva@gmail.com

Journal Francais D'Ophtalmologie
|June 18, 2011
PubMed
Summary
This summary is machine-generated.

Calciphylaxis, a rare condition, can cause vision loss in hemodialysis patients. Prompt diagnosis via repeat temporal artery biopsy is crucial for preventing irreversible blindness.

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Area of Science:

  • Vascular Medicine
  • Nephrology
  • Ophthalmology

Background:

  • Calciphylaxis is a severe complication in patients with end-stage renal disease, often presenting with painful skin necrosis.
  • Optic neuropathy is an uncommon but devastating manifestation of calciphylaxis, leading to potential vision loss.

Observation:

  • A 51-year-old hemodialysis patient presented with progressive visual loss in both eyes.
  • Skin necrosis on digits and thighs, along with optic disc edema, were noted.
  • Initial temporal artery biopsy was inconclusive, but a repeat biopsy revealed extensive calcification.

Findings:

  • The patient was diagnosed with optic neuropathy secondary to calciphylaxis.
  • Arterial calcification in the temporal artery's tunica media confirmed the diagnosis.
  • Cutaneous lesion biopsy showed calcification within small artery walls.

Implications:

  • Repeat temporal artery biopsy is essential when initial results are negative but suspicion remains high.
  • Early diagnosis and treatment of calciphylaxis-related optic neuropathy can prevent permanent vision impairment.
  • This case highlights the importance of considering calciphylaxis in hemodialysis patients with unexplained visual disturbances and skin lesions.