Acute Macular Outer Retinopathy and Acute Vision Loss Associated With Electrolyte Derangements and Rapid Repletion

Purpose: To describe a unique case of acute macular outer retinopathy presenting immediately after rapid correction of severe hypokalemia and hypomagnesemia, and to explore the potential association between electrolyte repletion and outer retinal injury. Methods: A single clinical case was retrospectively reviewed. Results: A 29-year-old woman presented with acute macular outer retinopathy and vision loss immediately following rapid intravenous electrolyte replacement. Optical coherence tomography revealed disruption of the outer retinal layers, and microperimetry demonstrated a corresponding decrease in retinal sensitivity. The patient was monitored over 5 months without intervention and achieved visual stability with partial improvement of outer retinal structure on imaging. Conclusions: This case highlights a potential relationship between rapid variations in systemic electrolyte concentrations and the development of acute macular outer retinopathy. The findings emphasize the importance of caution during rapid electrolyte repletion and suggest that multimodal retinal imaging may be valuable in monitoring visual symptoms that arise during or after electrolyte correction.