Uremic Optic Neuropathy in Chronic Renal Failure.

Lee, Ji Min; Hong, Samin; Kim, Chan Yun; Seong, Gong Je

doi:2016.57.7.1187

J Korean Ophthalmol Soc > Volume 57(7); 2016 > Article

Case Report

Journal of the Korean Ophthalmological Society 2016;57(7):1187-1191.
DOI: https://doi.org/10.3341/jkos.2016.57.7.1187 Published online July 15, 2016.

Uremic Optic Neuropathy in Chronic Renal Failure.

Ji Min Lee, Samin Hong, Chan Yun Kim, Gong Je Seong

¹The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. samini@yuhs.ac
²Hong Samin Optic Nerve Regeneration and Stem Cell Research Institute, Seoul, Korea.
³Hong Samin Yonsei Eye Clinic, Seoul, Korea.

만성 신부전 환자에서 발생한 요독성 시신경병증

이지민¹⋅홍사민^1,2,3⋅김찬윤¹⋅성공제¹

연세대학교 의과대학 안과학교실 시기능개발연구소¹, 홍사민시신경재생줄기세포연구소², 홍사민연세안과의원³

Abstract

PURPOSE
To report a case of uremic optic neuropathy occurring in a patient with chronic renal failure. CASE SUMMARY: A 40-year-old male who was diagnosed with chronic renal failure and treated with peritoneal dialysis and hemodialysis for 17 years presented with blurred vision and a moving pain in his left eye for 2 days. The best corrected visual acuity (BCVA) was 0.2 in his left eye, and an inferior altitudinal visual field defect was noted on Humphrey perimetry. Fundus examination and optical coherence tomography showed optic disc swelling in his left eye; the right eye was unremarkable. These findings were compatible with a diagnosis of uremic optic neuropathy or anterior ischemic optic neuropathy of his left eye. After treatment of hemodialysis and intravenous high dose steroid pulse therapy, the BCVA in his left eye was 0.8. However, since he refused oral steroid maintenance therapy, his BCVA later decreased to 0.4. After treatment with subtenon triamcinolone injection, the BCVA in his left eye was 1.0 and showed a stable disease course. CONCLUSIONS: When patient with chronic renal failure presents with acute decrease in visual acuity and visual field defect, optic neuropathies including uremic optic neuropathy should be considered and prompt hemodialysis and systemic steroid treatment should be done.

Key Words: Hemodialysis;Uremia;Uremic optic neuropathy