Retinal involvement in nephrotic syndrome secondary to minimal change disease.

Purpose: Nephrotic syndrome is a kidney disorder characterized by loss of different plasmatic proteins resulting in different peripheral tissue edemas. No ocular complications have been reported in nephrotic syndrome secondary to primary glomerular disease.

Methods: A 24-year-old woman was referred to emergency service for acute generalized edema, associated with bilateral visual impairment and metamorphopsia. A diagnosis of nephrotic syndrome was made. The patient was treated with diuretic therapy.

Results: At first ophthalmologic evaluation, the woman presented best-corrected visual acuity of 20/32 in the right eye and 20/40 in the left eye and a dome-shaped bilateral neurosensorial retinal detachment and macular edema studied with spectral-domain optical coherence tomography. The patient underwent furosemide treatment. At follow-up evaluation 6 days later, best-corrected visual acuity improved to 20/20 in both eyes and restoration of normal retinal anatomy was demonstrated.

Conclusions: Sequestration of interstitial fluids, which leads to classic generalized edema in nephrotic syndrome, could be the origin of interstitial accumulation of fluids in the retinal layers.