RETINAL SEPARATION IN CHRONIC GLOMERULONEPHRITIS. REPORT OF A PATIENT CURED BY BILATERAL NEPHRECTOMIES AND SUBSEQUENT SUCCESSFUL KIDNEY TRANSPLANT

Increased Subfoveal Choroidal Thickness and Retinal Structure Changes on Optical Coherence Tomography in Pediatric Alport Syndrome Patients

Objective

To evaluate optical coherence tomography (OCT) findings of pediatric Alport syndrome (AS) patients with no retinal pathology on fundus examination.

Materials and Methods

Twenty-one patients being followed up with the diagnosis of AS (Group 1) and 24 age- and sex-matched healthy volunteers (Group 2) were prospectively evaluated. All participants underwent standard ophthalmologic examination, retinal nerve fibre layer (RNFL) analysis, and horizontal and vertical scan macula enhanced depth imaging OCT (EDI-OCT). Statistical analysis of the data obtained in this study was performed with SPSS 15.0.

Results

Macula thickness was significantly decreased in the temporal quadrant in Group 1 compared to those of the control group (p=0.013). RNFL measurements revealed statistically significant thinning in the temporal, superior, inferotemporal, and inferonasal quadrants and in average thicknesses in cases with AS compared to the controls (p < 0.001, p < 0.001, p=0.022, p=0.016, p < 0.001, respectively). The mean subfoveal coronial thickness (SCT) was 362.2 ± 77.8 μm in Group 1 and 256,18 ± 71.7 μm in Group 2. There was a statistically significant difference between the two groups in terms of mean CT (p < 0.001).

Conclusion

OCT provides valuable information in identifying the structural changes and evaluation of ocular findings in patients with AS. Even if no pathological retinal findings were found in the clinical examination, structural changes in the OCT examination begin in early period of AS.

Fundus changes in mesangiocapillary glomerulonephritis type II: clinical and fluorescein angiographic findings

Previously we have demonstrated a deposit in Bruch's membrane in a single case of mesangiocapillary glomerulonephritis type II. We studied a group of patients with this disease and described extensive clinical and fluorescein angiographic abnormalities, which were in marked contrast to the findings in a group of patients with other forms of glomerulonephritis. This finding contributes to our understanding of the pathophysiology of the complex of the retinal pigment epithelium, Bruch's membrane, and choriocapillaris.

Fundus changes in (type II) mesangiocapillary glomerulonephritis simulating drusen: a histopathological report

We report for the first time to our knowledge the histopathological findings in the eye of a patient with type II mesangiocapillary glomerulonephritis (dense deposit disease) in which a deposit of material morphologically very similar to that which is pathognomonic for the disease in the kidney was demonstrated in Bruch's membrane. The nature of the deposit in the renal lesion is unknown but is considered to represent a structural alteration secondary to a reaction with anticomplement antibody. Clinically the fundus appearance resembled that seen in drusen.

Ocular manifestations of Alport's syndrome: a hereditary disorder of basement membranes?

The ocular manifestations in 16 patients with Alport's syndrome were lenticonus and retinal flecks in the macula and mid periphery. These 3 features appear to be specific for this syndrome and are a considerable aid to diagnosis. Lens opacities are common, and other ocular abnormalities occur sporadically. The present evidence indicates that this is a hereditary, widespread disorder of basement membrane, and it is suggested that ophthalmologists may contribute to the further understanding of it by directing attention towards analysis of the lens capsule after cataract extraction. The similarity of the retinopathy to that of fundus albipunctatus is noted, and it is suggested that the latter condition should not be diagnosed in the absence of renal investigation and audiometry.

Periarteritis nodosa and thrombotic thrombocytopenic purpura with serous retinal detachment in siblings

Periarteritis nodosa and thrombotic thrombocytopenic purpura in siblings is reported. In both patients a localised serous retinal detachment and lesions of the retinal pigment epithelium had developed owing to choroidal vascular obstruction. These cases support the suggested possible relationship between the two conditions.

Ocular clinical findings and basement membrane changes in Goodpasture's syndrome

Goodpasture's syndrome is a rapidly progressive disease characterized by the onset of pulmonary hemorrhage with glomerulonephritis, leading to pulmonary and renal failure. The hallmark of this disease is linear deposition of antibasement membrane IgG in the basement membranes of the kidney and lung. In two cases of nonrhegmatogenous retinal detachment in patients with Goodpasture's syndrome, the first patient demonstrated multiple ischemic areas in the choroid on fluorescein angiography. Histopathologic and immunologic studies of the eyes in the second patient demonstrated macular edema and elevation of the retina in association with choroidal infarction and linear deposition of IgG in Burch's membrane and the basement membranes of the choroidal vessels.

Retinal detachment with spontaneous regression in renal failure

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