Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysis
Purpose: To report two cases of catastrophic retinal vascular occlusion and crystalline retinopathy due to presumed oxalosis and hyperphosphatemia. Observations: We describe two unrelated patients with end-stage kidney failure (ESKD) treated with peritoneal dialysis that developed rapid bilateral vi...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624001634 |
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| author | Delu Song Charles Ginsberg Eric Nudleman Shyamanga Borooah Andrew King Elodie Bousquet David Sarraf Michael Goldbaum |
| author_facet | Delu Song Charles Ginsberg Eric Nudleman Shyamanga Borooah Andrew King Elodie Bousquet David Sarraf Michael Goldbaum |
| author_sort | Delu Song |
| collection | DOAJ |
| description | Purpose: To report two cases of catastrophic retinal vascular occlusion and crystalline retinopathy due to presumed oxalosis and hyperphosphatemia. Observations: We describe two unrelated patients with end-stage kidney failure (ESKD) treated with peritoneal dialysis that developed rapid bilateral vision loss due to severe retinal vascular occlusion. Multi-modal retinal imaging studies demonstrated crystalline deposits. Plasma phosphorus and oxalate levels were markedly elevated compared to persons with normal kidney function. One patient harbored a heterozygous variant of unknown significance in the Alanine--Glyoxylate Aminotransferase (AGXT) gene. Intense hemodialysis and diet modification reduced phosphorus and oxalate levels. Conclusions and importance: This report serves to raise awareness of hyperphosphatemia and oxalosis in dialysis patients to alert providers so that they can act to decrease the potential risk of vision loss. |
| format | Article |
| id | doaj-art-9db1cd38b42948e5afdafa9a05116921 |
| institution | OA Journals |
| issn | 2451-9936 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-9db1cd38b42948e5afdafa9a051169212025-08-20T02:37:05ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-013610215310.1016/j.ajoc.2024.102153Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysisDelu Song0Charles Ginsberg1Eric Nudleman2Shyamanga Borooah3Andrew King4Elodie Bousquet5David Sarraf6Michael Goldbaum7Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, USA; San Diego Retina Associates, San Diego, CA, USA; Corresponding author. Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California at San Diego, USA.Division of Nephrology-Hypertension, UC San Diego, La Jolla, CA, USAShiley Eye Institute, The Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, USAShiley Eye Institute, The Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, USADepartment of Nephrology, Scripps Clinic, La Jolla, CA, USAStein Eye Institute, UC Los Angeles, Los Angeles, CA, USAStein Eye Institute, UC Los Angeles, Los Angeles, CA, USAShiley Eye Institute, The Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, USA; Corresponding author. Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California at San Diego, USA.Purpose: To report two cases of catastrophic retinal vascular occlusion and crystalline retinopathy due to presumed oxalosis and hyperphosphatemia. Observations: We describe two unrelated patients with end-stage kidney failure (ESKD) treated with peritoneal dialysis that developed rapid bilateral vision loss due to severe retinal vascular occlusion. Multi-modal retinal imaging studies demonstrated crystalline deposits. Plasma phosphorus and oxalate levels were markedly elevated compared to persons with normal kidney function. One patient harbored a heterozygous variant of unknown significance in the Alanine--Glyoxylate Aminotransferase (AGXT) gene. Intense hemodialysis and diet modification reduced phosphorus and oxalate levels. Conclusions and importance: This report serves to raise awareness of hyperphosphatemia and oxalosis in dialysis patients to alert providers so that they can act to decrease the potential risk of vision loss.http://www.sciencedirect.com/science/article/pii/S2451993624001634Crystalline retinopathyOxalatePhosphorusOcclusive retinopathyVision loss |
| spellingShingle | Delu Song Charles Ginsberg Eric Nudleman Shyamanga Borooah Andrew King Elodie Bousquet David Sarraf Michael Goldbaum Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysis American Journal of Ophthalmology Case Reports Crystalline retinopathy Oxalate Phosphorus Occlusive retinopathy Vision loss |
| title | Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysis |
| title_full | Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysis |
| title_fullStr | Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysis |
| title_full_unstemmed | Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysis |
| title_short | Catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end-stage kidney disease treated with peritoneal dialysis |
| title_sort | catastrophic retinal vascular occlusion and vision loss due to crystal deposition in end stage kidney disease treated with peritoneal dialysis |
| topic | Crystalline retinopathy Oxalate Phosphorus Occlusive retinopathy Vision loss |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624001634 |
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