Posterior Chorioretinopathy and Retinal Detachment After Organ Transplantation

Gass, J. Donald M.; Slamovits, Thomas L.; Fuller, Dwain G.; Gieser, Richard G.; Lean, John S.

doi:10.1001/archopht.1992.01080240057030

Cited by 57 publications

(28 citation statements)

References 13 publications

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“…Some patients with SLE are reported to develop this disease. The changes generally observed in the patients are clumping and mottling of the RPE, focal detachment of the RPE and/or serous elevation and detachment of the neurosensory retina (Matsuo et al, 1987;Gass et al, 1992;Eckstein et al, 1993;Carpenter et al, 1994;Polak et al, 1995;Cunningham et al, 1996;Hsiao and Yang, 1998;Khng et al, 2000). In idiopathic central serous chorioretinopathy, the occlusion of choroidal arteries and the resultant increased hydrostatic pressure are suggested to cause damage to the overlying RPE.…”

Section: Ii) Central Serous Chorioretinopathy In Slementioning

confidence: 99%

Vascular Changes of the Retina and Choroid in Systemic Lupus Erythematosus: Pathology and Pathogenesis

Nag¹,

Wadhwa

2006

CNR

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that affects multiple organ systems. When eyes are involved, the principle manifestations are hemorrhage, retinal cotton wool spots, microangiopathy and vaso-occlusion. Research in the past two decades has significantly contributed to our understanding about this disease in general and its therapeutic management, although knowledge about the mechanism of ocular involvement and pathogenesis in SLE is limited. This is an important issue, because the ocular symptoms in this disease could be potentially sight threatening in acute cases. Here, we present an overview of the clinical and histopathologic features of retinal and choroidal vascular changes, as seen in patients with SLE. We discuss the role of immune complex deposition in vascular pathogenesis in the eye. Reports indicated an involvement of antiphospholipid antibodies (APAs) in the retinal and choroidal vasculopathy in SLE, although their precise role in this process is uncertain. It is important to look for mechanisms of immune complex-mediated vasculopathy and role of inflammatory mediators in this process in SLE. For this, established animal models can be utilized in research to learn about the precise role of various autoantibodies and complements involved in disease pathogenesis. A clear knowledge about the immunopathogenesis is warranted, and the rationale for the future therapy should be based on reducing vascular inflammation as well as ameliorating autoimmunity in this disease.

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Section: Ii) Central Serous Chorioretinopathy In Slementioning

confidence: 99%

Vascular Changes of the Retina and Choroid in Systemic Lupus Erythematosus: Pathology and Pathogenesis

Nag¹,

Wadhwa

2006

CNR

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“…6 Our patient did not have organ transplantation as a risk factor and no choroidal neovascularisation was seen on FFA. Polk and colleagues 7 described a case with sub-retinal fluid unilaterally due to possible atypical ICSC but that patient had drusen and longstanding type 2 MPGN with renal transplant.…”

Section: Discussionmentioning

confidence: 61%

Bilateral macular sub‐retinal fluid and retinal pigment epithelial detachment associated with type 2 membrano‐proliferative glomerulonephritis

Awan

Grierson

Walker

2008

Clinical and Experimental Optometry

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Choroidal neovascularisation (CNV) and idiopathic central serous chorioretinopathy (ICSC) are recognised ocular complications related to type 2 membrano-proliferative glomerulonephritis. We report a 38-year-old white male who presented with a 10-day history of blurring of vision, micropsia and metamorphopsia. He had been diagnosed recently to have type 2 membrano-proliferative glomerulonephritis. On examination, there was bilateral retinal pigment epithelial (RPE) detachment with overlying subretinal fluid without any drusen. Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) confirmed the diagnosis of atypical ICSC. Three months later, sub-retinal fluid and RPE detachment resolved and VA had recovered to 6/6. The case highlights the importance of ophthalmological assessment in these patients to recognise sight-threatening complications. Key words: glomerulonephritis, macula, retinal pigment epithelial detachment Type 2 membrano-proliferative glomerulonephritis (MPGN) is an early adulthood disease, which usually presents as proteinuria, haematuria and renal impairment.1 MPGN, also known as dense deposit disease, is characterised pathologically by electron dense deposits on the basement membranes in the glomeruli of the kidney and similar changes in Bruch's membrane are also seen.2 Duvall-Young, MacDonald and McKechnie 3 were the first to describe the association of retinal pigment epithelial (RPE) changes and this disease in 1989. They demonstrated that the electron microscopic appearance of these dense deposits in the glomerular capillary basement membrane and Bruch's membrane are similar. 3Choroidal neovascularisation and idiopathic central serous chorioretinopathy (ICSC) are recognised ocular complications related to the electron dense deposits in this disease. 4 We report a case that presented with bilateral pigment epithelial detachment (PED) with overlying subretinal fluid and describe fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) findings in this patient. CASE REPORTA 38-year-old white male presented with a 10-day history of blurring of vision, micropsia and metamorphopsia in both eyes. Past ocular history did not reveal any previous ocular problems. Four months earlier, he had been diagnosed with type 2 MPGN, which was confirmed on renal biopsy. He also had systemic hypertension, hyperlipidaemia, vitamin B12 deficiency and folate deficiency secondary to chronic renal failure.On examination distance visual acuity (VA) was 6/9 in the right eye and 6/12 in the left eye, which improved to 6/6 with pin hole. Near VA was N10 and N12 in the right and left eyes, respectively. Amsler grid testing showed central distortion. Anterior segment examination was normal in both eyes. There was no relative afferent papillary defect (RAPD). Fundus examination showed an elevated area overlying the macula in both eyes.

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“…Anterior segm ent complications, such as corneal and conjunctival calcifications and subcapsular cataract, have been well d e scribed. 7,9,11"14 Recent reports have m en tio n e d p a th o lo g ic a l c h a n g e s in the posterior segment: chorioretinopathy, 17 op tic disc edem a, 10 serous retinal detach m e n t,lH and cottoivw ool sp o ts.1 1 ) The prevalence and pathogenesis of these le sions, however, remain a matter of specu lation.…”

Section: Resultsmentioning

confidence: 99%