Title : Multiple PEDs in Nephrotic Syndrome
Abstract:
This is the case report of a 31-year-old male, known case of Nephrotic syndrome, secondary to Membranoproliferative glomerulonephritis(MPGN) diagnosed on kidney biopsy referred for fundus examination. On examination, he had a BCVA of 6/6 in both the eyes with normal intraocular pressures and clear lenses. Fundus examination showed multiple small pigment epithelial detachments(PED) throughout the mid periphery and temporal to the macula in both the eyes confirmed on Optical coherence tomography scans better appreciated on autofluorescence.There was no evidence of any vitritis or any vascular involvement.Clinical exome sequencing did not reveal any significant gene mutation. Full field ERG and multifocal ERG ruled out any inherited retinal dystrophy. Fluorescein angiography could not be done as the patient had high creatinine levels. He was not on any form of corticosteroid treatment.At 1year follow up, the PEDs showed no change in character or size and the visual acuity remained stable.
Clinical Implication- Bilaterality, lack of vascular/disc involvement and stability of PEDs over 1 year point towards our diagnosis of CSCR secondary to fluid retention in nephrotic syndrome. As such ophthalmologists should be aware of this uncommon but life threatening association of CSCR with kidney diseases.
