PDF(Pubmed)
Abstract：
Nephrotic syndrome is a disease that causes fluid retention in the body due to loss of protein in the blood, which can lead to serous retinal detachment (SRD) in the macula. We report a case of severe SRD in both eyes and angle closure due to ciliary body edema caused by nephrotic syndrome. A 57-year-old man was admitted to the Department of Nephrology in our hospital for a thorough examination of his generalized edema. He was diagnosed with nephrotic syndrome but proved to be refractory to steroid treatment. Due to distortion symptoms in both eyes on the 30th day of hospitalization, the patient was referred to our department. Best-corrected visual acuity (BCVA) was 0.8 in the right eye and 1.0 in the left eye. Slit lamp examination and anterior segmental optical coherence tomography (OCT) showed shallow anterior chambers in both eyes. Fundus and macular OCT demonstrated severe SRD in the posterior pole of both eyes. After observing the presence of hypoalbuminemia, we considered the possibility of SRD and angle closure due to ciliary edema that resulted from the leaks associated with the nephrotic syndrome. Thereafter, ocular findings improved in conjunction with systemic symptom improvements associated with ultrafiltration and low-density lipoprotein apheresis. On the 60th day of hospitalization, his BCVA improved to 1.2 in both eyes, SRD disappeared, and the anterior chamber depth normalized. This case demonstrates the importance of recognizing SRD and angle closure associated with ciliary body edema as complications linked with nephrotic syndrome.
摘要：
肾病综合征是一种由于血液中蛋白质丢失而导致体内液体潴留的疾病，这可能导致黄斑浆液性视网膜脱离（SRD）。我们报告了一例由于肾病综合征引起的睫状体水肿而导致的双眼严重SRD和闭角。一名57岁的男子被送进我们医院的肾内科，对他的全身性水肿进行彻底检查。他被诊断为肾病综合征，但被证明对类固醇治疗无效。由于住院第30天双眼出现扭曲症状，病人被转介到我们部门。右眼最佳矫正视力（BCVA）为0.8，左眼为1.0。裂隙灯检查和前节段光学相干断层扫描（OCT）显示双眼浅前房。眼底和黄斑OCT显示双眼后极严重SRD。在观察到低蛋白血症的存在后，我们考虑了由与肾病综合征相关的渗漏引起的睫状水肿引起的SRD和房角闭合的可能性.此后,与超滤和低密度脂蛋白单采术相关的全身症状改善以及眼部发现改善.在住院的第60天，他的双眼BCVA都提高到1.2，SRD消失了,前房深度正常化。此病例证明了认识到与睫状体水肿相关的SRD和闭角是与肾病综合征相关的并发症的重要性。
