Severe bilateral visual loss as the first sign of IgA nephropathy

ABSTRACT We describe a case of a 33-years-old woman who presents with severe acute bilateral visual loss secondary to massive exudative hypertensive maculopathy as the first sign of immunoglobulin A nephropathy. The patient’s ophthalmic examination showed bilateral cotton-wool spots, flame-shaped retinal hemorrhages, diffuse narrow arterioles, optic disk edema, and exudative maculopathy. Systemic workup demonstrated a systolic and diastolic blood pressure of 240 mmHg and 160 mmHg, respectively, proteinuria, and hematuria, suggesting kidney disease as the causative condition. A kidney biopsy confirmed immunoglobulin A nephropathy. She was treated with systemic corticosteroids, antihypertensive drugs, and a single bilateral intravitreal injection of aflibercept. There was a prompt resolution of macular edema and vision improvement. Our case draws attention to the fact that severe bilateral visual loss can be the first sign of severe hypertension. Secondary causes, such as immunoglobulin A nephropathy, should be ruled out.

Bibliographic Details

Main Authors:	Cunha,Leonardo Provetti, Defina,Raphael Lucas Sampaio, Preti,Rony Carlos, Costa-Cunha,Luciana Virgínia Ferreira, Zacharias,Leandro Cabral, Hokazono,Kenzo, Monteiro,Mário Luiz Ribeiro
Format:	Digital revista
Language:	English
Published:	Conselho Brasileiro de Oftalmologia 2022
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492022005007205
Tags:	Add Tag No Tags, Be the first to tag this record!