Retinal involvement in nephrotic syndrome secondary to minimal change disease

Nephrotic syndrome is a kidney disorder characterized by loss of different plasmatic proteins resulting in different peripheral tissue edemas. No ocular complications have been reported in nephrotic syndrome secondary to primary glomerular disease.

A 24-year-old woman was referred to emergency service for acute generalized edema, associated with bilateral visual impairment and metamorphopsia. A diagnosis of nephrotic syndrome was made. The patient was treated with diuretic therapy.

At first ophthalmologic evaluation, the woman presented best-corrected visual acuity of 20/32 in the right eye and 20/40 in the left eye and a dome-shaped bilateral neurosensorial retinal detachment and macular edema studied with spectral-domain optical coherence tomography. The patient underwent furosemide treatment. At follow-up evaluation 6 days later, best-corrected visual acuity improved to 20/20 in both eyes and restoration of normal retinal anatomy was demonstrated.

Sequestration of interstitial fluids, which leads to classic generalized edema in nephrotic syndrome, could be the origin of interstitial accumulation of fluids in the retinal layers.