Progressive Subretinal Fibrosis in a Child Following Hemolytic Uremic Syndrome

Krott, Ralf; Querfeld, Uwe; Bartz-Schmidt, U.; Hammers, Helmut; Hammers, Wolfgang; Heimann, Klaus

doi:10.1097/00006982-199901000-00014

Cited by 7 publications

(3 citation statements)

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“…Our study identified three children (4%) with ocular involvement in HUS. This is remarkable as there are no recent reports on the frequency and severity of ocular abnormalities in paediatric HUS except for three which cite single cases (Lauer et al 1998;Krott et al 1999;Larakeb et al 2007). All three affected patients in our study suffered from D+ HUS.…”

Section: Discussionmentioning

confidence: 96%

“…Optic atrophy as seen in patients 2 and 3 might cause a severe decrease in VA and blindness (Sheth et al 1986;Siegler et al 1988). Visionimpairing secondary bilateral progressive subretinal fibrosis developed several years after acute HUS in one case (Krott et al 1999). However, no ocular pathology was detected during acute HUS and fundus abnormalities could not be attributed to a special pathomechanism.…”

Section: Discussionmentioning

confidence: 97%

“…Ocular involvement in paediatric patients with HUS has only rarely been reported, although the retinal microvasculature can easily be observed by funduscopy, unlike all other microvascular networks in the human body (Sheth et al 1986;Siegler et al 1988;Lauer et al 1998;Krott et al 1999;Larakeb et al 2007). Previous ocular findings include retinal, choroidal and vitreal haemorrhages as well as ischaemic signs such as cottonwool spots, retinal whitening and non-perfusion zones.…”

Section: Introductionmentioning

confidence: 99%

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Ocular involvement in paediatric haemolytic uraemic syndrome

Sturm

Menke

Landau

et al. 2009

Acta Ophthalmologica

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Acta Ophthalmol. 2010: 88: 804–807 Abstract. Purpose: The aim of this study was to estimate the frequency and severity of ocular involvement in paediatric patients with haemolytic uraemic syndrome (HUS). Methods: The study was designed as an institutional, retrospective, observational case series. Charts for all 87 paediatric patients with HUS treated at the University Children’s Hospital Zurich between 1995 and 2007 were reviewed. Patients with ocular involvement were identified and clinical findings presented. Results: Three of 69 examined patients with HUS showed ocular involvement. Ophthalmic findings in two children were consistent with bilateral Purtscher retinopathy, showing multiple haemorrhages, exudations and superficial retinal whitening. The third child presented with bilateral isolated central intraretinal haemorrhages as a milder form of ocular involvement. In one of the children with Purtscher retinopathy, laser photocoagulation was required for bilateral rubeosis irides and development of disc neovascularization. Longterm outcomes in the two severely affected children showed decreased visual acuity caused by partial atrophy of the optic nerves. In the milder case visual acuity was not impaired at any time. Conclusions: A minority of paediatric patients with HUS developed ocular involvement. Acute ocular findings varied in severity from isolated intraretinal haemorrhages to Purtscher‐like retinopathy with retinal ischaemia. Longterm complications included the development of neovascularizations and consecutive optic nerve atrophy. Although ocular involvement in HUS seems to be rare, physicians should be aware of this complication because of its possible vision‐endangering consequences.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ocular involvement in paediatric haemolytic uraemic syndrome

Sturm

Menke

Landau

et al. 2009

Acta Ophthalmologica

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Vitrektomie bei retinaler Proliferation im Kindesalter nach hämolytisch-urämischem Syndrom

2015

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The formation of retinal membranes can occur due to a variety of reasons but they are most commonly idiopathic due to the aging process. In addition, epiretinal and subretinal membranes can be formed after severe infections. The present case description shows the appearance of a retinal membrane after hemolytic uremic syndrome caused by Shiga toxin positive E. coli. The question arose whether the patient would benefit from vitrectomy with membrane peeling because of the presence of both epiretinal and subretinal gliotic changes. After the operation on the more severely affected right eye a morphological improvement could be achieved so that an operation on the left eye was also recommended. Judging by the course of this case vitrectomy with membrane peeling seems to be a useful instrument even for the simultaneous presence of subretinal and epiretinal membranes.

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