Severe bilateral visual loss as the first sign of IgA nephropathy.

Cunha, Leonardo Provetti; Defina, Raphael Lucas Sampaio; Preti, Rony Carlos; Costa-Cunha, Luciana Virgínia Ferreira; Zacharias, Leandro Cabral; Hokazono, Kenzo; Monteiro, Mário Luiz Ribeiro

Cunha, Leonardo Provetti; Defina, Raphael Lucas Sampaio; Preti, Rony Carlos; Costa-Cunha, Luciana Virgínia Ferreira; Zacharias, Leandro Cabral; Hokazono, Kenzo; Monteiro, Mário Luiz Ribeiro.

Afiliação

Cunha LP; Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
Defina RLS; Postgraduate Program, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Preti RC; Hospital de Olhos de Juiz de Fora, Juiz de Fora, MG, Brazil.
Costa-Cunha LVF; Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
Zacharias LC; Postgraduate Program, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Hokazono K; Hospital de Olhos de Juiz de Fora, Juiz de Fora, MG, Brazil.
Monteiro MLR; Postgraduate Program, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Arq Bras Oftalmol ; 2022 Jul 15.

Article em En | MEDLINE | ID: mdl-35857983

RESUMO

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.

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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Arq Bras Oftalmol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil

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