Sweet poison: Retinopathy induced by fructose toxicity. A case report

To describe a case of severe bilateral ischemic retinopathy in a non-diabetic, obese patient following a diet high in liquid fructose.

A 44-year-old non-diabetic, obese patient, following a meal replacement diet with shakes containing high amounts of fructose, presented with painless visual loss of several weeks in his right eye (RE) and was diagnosed with a severe ischemic retinopathy and Non-Alcoholic Steatohepatitis (NASH). We hypothesize that fructose toxicity due to the formation of reactive oxygen species (ROS) and advanced glycation end products (AGEs) played a central role not only in the hepatic but also in the retinal pathology.

Rapid deterioration of his condition resulted in multisystem failure. Despite medical interventions, the patient died within 5 months of the initial ophthalmological diagnosis.

This case suggests that, in certain individuals, excessive fructose intake may contribute to ocular damage.