Bilateral Serous Retinal Detachment in a Case with Nephrotic Syndrome

Purpose: To present a case with nephrotic syndrome who developed serous retinal detachment in bilateral eyes.

Case Report: A 38-year-old man went to nephrology department due to bilateral leg edema and foamy urine. A diagnosis of focal segmental glomerularsclerosis with nephrotic syndrome was made and proved by kidney biopsy. Bilateral blurred vision was noted 3 months later with best corrected visual acuity (BCVA) 20/125 in right eye and 20/100 in left eye. Anterior segment and intraocular pressure were normal in both eyes. No intraocular inflammation was observed. Fundus examination showed bilateral submacular fluid. The patient was treated with diuretic, albumin supplement and steroid therapy and BCVA improved to 20/100 and 20/32 one month later. Optical coherence tomography (OCT) still revealed massive submacular fluid in both eyes. Steroid was replaced by cyclosporin A owing to intolerance of the side effect of steroid. Another one month later, BCVA improved to 20/40 and 20/25. No subretinal fluid was found by OCT in both eyes. Almost restoration of retinal anatomy was demonstrated except for some retinal pigment epithelial undulation.

Conclusion: Bilateral serous retinal detachment can rarely occur in patients with nephrotic syndrome. Serous retinal detachments can resolve with good visual prognosis with early recognition and proper medical treatment of nephrotic syndrome. Residual retinal pigment epithelial undulation can be found after the episode.

Keywords: serous retinal detachment; nephrotic syndrome; retinal pigment epithelial undulation; optical coherence tomography.