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Retinal oxalosis. A clinicopathologic report.
C G Wells1, R J Johnson, L Qingli
1Department of Ophthalmology, University of Washington, School of Medicine, Seattle.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|November 1, 1989
Summary
Systemic oxalosis caused severe vision loss in a hemodialysis patient due to retinal artery crystals. Contributing factors included renal failure, ascorbic acid, pyridoxine deficiency, and ileal resection.
Area of Science:
- Ophthalmology
- Nephrology
- Metabolic Disorders
Background:
- Chronic renal failure and hemodialysis can predispose patients to metabolic complications.
- Systemic oxalosis is a rare condition characterized by oxalate deposition in various organs.
- Ocular manifestations of systemic oxalosis can lead to significant visual impairment.
Observation:
- A 55-year-old woman on hemodialysis presented with severe bilateral visual loss.
- Ophthalmoscopy revealed crystals within retinal arteries, indicative of retinal ischemia.
- The clinical presentation and findings suggested a diagnosis of systemic oxalosis.
Findings:
- Histopathology confirmed calcium oxalate deposition predominantly in the walls of retinal blood vessels.
- Contributing factors identified were chronic renal failure, ascorbic acid supplementation, pyridoxine deficiency, and prior ileal resection.
- The ocular findings were directly linked to oxalate deposition in the retinal vasculature.
Implications:
- This case highlights the importance of recognizing systemic oxalosis in patients with chronic kidney disease presenting with visual disturbances.
- Identifying and managing contributing factors like ascorbic acid intake and nutritional deficiencies is crucial.
- Early diagnosis and intervention may help prevent irreversible vision loss in susceptible individuals.