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Hypertensive crisis with massive retinal and choroidal infarction: A case update
Sarah A Avila1,2, Cyrus Golshani1,2, Alan H Friedman1,3
1Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, USA.
American Journal of Ophthalmology Case Reports
|December 7, 2018
Summary
Uncontrolled hypertension from immunoglobulin A (IgA) nephropathy caused severe vision loss due to retinal infarction. Autoimmune kidney disease increases risk for these devastating eye complications.
Area of Science:
- Ophthalmology
- Nephrology
- Immunology
Background:
- A case of uncontrolled hypertension secondary to immunoglobulin A (IgA) nephropathy leading to retinal and choroidal infarction was previously reported.
- The patient, a 30-year-old female with end-stage renal disease, experienced vision loss due to hypertensive crisis and subsequent infarction.
Observation:
- The patient presented with a painful blind right eye and decreased vision in the left eye.
- Complications included neovascular glaucoma in the right eye and tractional retinal detachment in the left eye.
- Immunohistopathology confirmed IgA nephropathy through IgA deposition.
Findings:
- Hypertensive retinopathy is a severe complication of end-stage renal disease.
- There is a strong correlation between the severity of retinopathy and kidney function.
- Patients with autoimmune renal diseases like IgA nephropathy face a higher risk of retinochoroidal complications.
Implications:
- This case highlights the devastating potential of hypertensive retinopathy in end-stage renal disease.
- Ophthalmologists and clinicians must conduct regular eye examinations for patients with autoimmune renal diseases.
- Early detection and management are crucial to prevent severe visual impairment in at-risk populations.
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