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Calciphylaxis, beware the ophthalmic mimic: A case series
Chelsea Guymer1, Sadia Jahan2, Bobak Bahrami1
1Department of Ophthalmology, and.
Clinical Nephrology. Case Studies
|January 3, 2024
Summary
Calciphylaxis can cause severe eye problems like vision loss, even without skin sores. Early diagnosis in kidney patients is key to proper treatment and avoiding misdiagnosis.
Area of Science:
- Ophthalmology
- Nephrology
- Pathology
Background:
- Calciphylaxis is a rare condition causing skin necrosis due to vascular calcification.
- Ocular involvement in calciphylaxis is uncommon, often presenting with severe visual impairment.
Observation:
- Two cases of atypical calciphylaxis presenting with ocular ischemic events are described.
- Case 1: A 76-year-old woman with pre-dialysis kidney failure experienced anterior ischemic optic neuropathy (AION) and cilioretinal artery occlusion.
- Case 2: A 44-year-old man on hemodialysis developed AION and contralateral central retinal artery occlusion (CRAO).
Findings:
- Both patients lacked the typical cutaneous manifestations of calciphylaxis.
- The ocular findings included microvascular ischemic pathology, specifically AION and CRAO.
- These presentations highlight the diagnostic challenge of calciphylaxis without skin lesions.
Implications:
- Clinical suspicion of calciphylaxis is crucial in kidney failure patients with unexplained ophthalmic vascular events.
- Temporal artery biopsy aids in confirming calciphylaxis and differentiating it from giant cell arteritis (GCA).
- Timely, multidisciplinary treatment is essential for managing calciphylaxis and preventing irreversible vision loss, avoiding unwarranted corticosteroid use.
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