Bilateral central serous chorioretinopathy in a patient with focal segmental glomerulosclerosis

Abstract

Abstract Purpose The central serous chorioretinopathy (CSCR) is a frequent ocular disease characterized by a serous detachment of the neurosensory retina at the posterior pole. This sporadic and self‐finished disease can become chronical in some cases, resulting in a degeneration and atrophy of the underlying retinal pigment epithelium (RPE). The more severe cases of CSCR had been recognized in patients treated with high systemic corticosteroid doses and in haemodialysis patients. Methods A 37‐year‐old‐man was attended in emergency with history of several days of blurring of vision. He was being haemodialysis by chronical renal failure secondary to a focal segmental glomerulosclerosis. The patient presented a visual acuity of 0,4 in the OR and 0,8 in the OL, with an image of bilateral CSCR on the fundus examination that was confirmed by optical coherence tomography (OCT). Results We reported the chronical evolution of the process until a kidney transplantation was done to the patient, reaching a spontaneous healing. Four and half months after the transplantation, evidences of a disappearance of sub‐retinal fluid with a persistence of drusen‐like retinal pigment epithelial alterations were found in the OCT‐image. Conclusion Immune‐complex deposits similar to the glomerular deposits can be identified near the Bruch membrane in patients with glomerulonephritis, these deposits prove the RPE‐barrier dysfunction and the appearance of disorders like macular drusens, sub‐retinal fluid or choroidal neovascularization. The case highlights the importance of ophthalmological assessment in these patients to recognise sight‐threatening complications.