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Optic neuropathy in uremia.

L M Hamed1, K E Winward, J S Glaser

  • 1Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.

American Journal of Ophthalmology
|July 15, 1989
PubMed
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Chronic hemodialysis patients can develop optic neuropathies. Discontinuing deferoxamine improved vision in one case, while others showed limited recovery, highlighting varied optic nerve disease in uremia.

Area of Science:

  • Ophthalmology
  • Nephrology
  • Neurology

Background:

  • Chronic hemodialysis is a vital treatment for end-stage renal disease.
  • Uremia and its treatments can present complex systemic complications.
  • Optic neuropathies are a potential, though not fully understood, complication in this patient population.

Observation:

  • Three patients undergoing chronic hemodialysis presented with distinct optic neuropathies.
  • Case 1: Severe bilateral vision loss resolved after deferoxamine cessation.
  • Case 2: Bilateral visual loss with papilledema due to increased intracranial pressure.
  • Case 3: Atypical anterior ischemic optic neuropathy.

Findings:

  • Deferoxamine chelation therapy was associated with vision recovery in one patient.

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  • Aggressive hemodialysis and methylprednisolone showed limited efficacy in two patients.
  • The observed optic neuropathies exhibited significant heterogeneity.

    • Implications:

    • These findings suggest a multifactorial etiology for optic nerve damage in hemodialysis patients.
    • Early recognition and potential modification of chelation therapy may be crucial.
    • Further research is needed to elucidate the mechanisms and optimize management strategies for uremic optic neuropathies.