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Severe bilateral visual loss as the first sign of IgA nephropathy

Arquivos brasileiros de oftalmologia, 2022-07, Vol.86 (6) [Peer Reviewed Journal]

This work is licensed under a Creative Commons Attribution 4.0 International License. ;ISSN: 0004-2749 ;ISSN: 1678-2925 ;EISSN: 1678-2925 ;DOI: 10.5935/0004-2749.2021-0314 ;PMID: 35857983

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  • Title:
    Severe bilateral visual loss as the first sign of IgA nephropathy
  • Author: Cunha, Leonardo Provetti ; Defina, Raphael Lucas Sampaio ; Preti, Rony Carlos ; Costa-Cunha, Luciana Virgínia Ferreira ; Zacharias, Leandro Cabral ; Hokazono, Kenzo ; Monteiro, Mário Luiz Ribeiro
  • Subjects: OPHTHALMOLOGY
  • Is Part Of: Arquivos brasileiros de oftalmologia, 2022-07, Vol.86 (6)
  • Description: 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.
  • Publisher: Brazil: Conselho Brasileiro de Oftalmologia
  • Language: English;Portuguese
  • Identifier: ISSN: 0004-2749
    ISSN: 1678-2925
    EISSN: 1678-2925
    DOI: 10.5935/0004-2749.2021-0314
    PMID: 35857983
  • Source: IngentaConnect Open Access
    SciELO
    Geneva Foundation Free Medical Journals at publisher websites
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