Bilateral Optic Atrophy in a Young Patient With Chronic Anaemia Secondary to End-Stage Renal Disease

Abstract

End-stage renal disease (ESRD) is associated with a number of serious complications, including increased cardiovascular disease, anaemia and metabolic bone disease. Optic atrophy secondary to chronic anaemia in ESRD is rare. We report a case of bilateral optic atrophy in a young patient with chronic anaemia secondary to ESRD. A 23-year-old lady with ESRD, presented with progressive blurring of vision in her left eye for a period of six months. Visual acuity in the left eye was counting finger and the right eye was 6/6. Left optic nerve functions were significantly reduced. Bilateral anterior segments and intraocular pressure were normal. Funduscopy showed bilateral pale disc with arteriolar attenuation. The infective, autoimmune and demyelinating screening were negative. Serial full blood count indicated low haemoglobin and haematocrit value. The full blood picture revealed normocytic normochromic anaemia. Neuroimaging was normal. The patient was diagnosed as having bilateral optic atrophy secondary to chronic anaemia due to ESRD. Chronic anaemia is a potential cause of optic atrophy in a young patient with chronic disease. Management of anaemia in such cases is crucial to prevent irreversible complications including optic atrophy and blindness.

Eye Lesions in Patients After One Year of Kidney Transplantation

“…The most common is chronic anemia in people with renal impairment leading to anemia that nourishes the optic nerve head. 9 , 18 In addition, due to vascular system disorders, renin-angiotensin damages the ganglion cell layer, the nerve fiber layer. 19 In the post-transplant stage, optic nerve atrophy is thought to be associated with post-transplant infection.…”

“… 8 Diagnosis of optic nerve atrophy was observed with a C/D ratio >0.6, and OCT optical tomography showed a decrease in the retinal nerve fiber layer < 85 μm. 9 The epiretinal membrane is diagnosed when a macular wrinkle is seen, and an OCT scan shows a membrane. Criteria for diagnosing dry eyes are the Schirmer Test < 10mm, the BUT< test 10 seconds, and OSDI > 10 points.…”

Deep-Learning-Based Hemoglobin Concentration Prediction and Anemia Screening Using Ultra-Wide Field Fundus Images

“…For example, patients with iron deficiency anemia (IDA) were reported to have significantly thinner peripapillary retinal nerve fiber layer (RNFL) thickness, and the Hgb levels were also significantly correlated with the average RNFL thickness value ( Türkyilmaz et al, 2013 ; Akdogan et al, 2015 ). Additionally, optic atrophy, disc edema, and epiretinal tissue on the optic disc have been identified in anemia patients ( Sethi et al, 2020 ; Ab Gani et al, 2021 ; Graf et al, 2021 ), which suggested that the optic disc was susceptible to be affected by anemia. Moreover, ASModel_UWF paid attention to the peripheral retina.…”