Sumeet Khanduja1, Brijesh Takkar2, Neha Khanduja3, Pradeep Venkatesh4. 1. Head of Department, Kalpana Chawla Government Medical College and Hospital, Karnal, Haryana, 132001, India. 2. Retina and Uvea Services, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. britak.aiims@gmail.com. 3. Department of Ophthalmology, IGMC, Shimla, Himachal Pradesh, India. 4. Retina and Uvea Services, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Abstract
PURPOSE: To report clinical features in a case of hyperviscosity retinopathy following post-renal transplant erythrocytosis (PTE) and its outcome after phlebotomy. METHODS: Fundus fluorescein angiography and optical coherence tomography (OCT) were carried out for a 29-year-old renal allograft recipient who presented with acute unilateral visual loss. RESULT: There was mild retinal vascular dilation in both eyes with retinal hemorrhages and retinal opaqueness in left eye. Cystoid macular edema was noted on OCT. Microvascular leaks and micro-occlusions were seen all around the foveal avascular zone on fluorescein angiogram. Investigations revealed hemoglobin to be 16.8 g%, and a PTE was diagnosed. The patient underwent phlebotomy following which there was near complete resolution of macular edema with improvement in vision. CONCLUSION: Hyperviscosity retinopathy can cause acute visual loss in cases of renal allograft recipients who develop PTE. Prompt management with phlebotomy can lead to reversal of macular edema in such cases.
PURPOSE: To report clinical features in a case of hyperviscosity retinopathy following post-renal transplant erythrocytosis (PTE) and its outcome after phlebotomy. METHODS: Fundus fluorescein angiography and optical coherence tomography (OCT) were carried out for a 29-year-old renal allograft recipient who presented with acute unilateral visual loss. RESULT: There was mild retinal vascular dilation in both eyes with retinal hemorrhages and retinal opaqueness in left eye. Cystoid macular edema was noted on OCT. Microvascular leaks and micro-occlusions were seen all around the foveal avascular zone on fluorescein angiogram. Investigations revealed hemoglobin to be 16.8 g%, and a PTE was diagnosed. The patient underwent phlebotomy following which there was near complete resolution of macular edema with improvement in vision. CONCLUSION:Hyperviscosity retinopathy can cause acute visual loss in cases of renal allograft recipients who develop PTE. Prompt management with phlebotomy can lead to reversal of macular edema in such cases.