title: A case of end-stage renal disease initially manifested with visual loss caused by uremic optic neuropathy.
abstract: Uremic optic neuropathy (UON) is extremely rare, although sporadic cases have been reported. UON is sometimes regarded as a manifestation of uremic neuropathy. Here, we report a case of end-stage renal disease presenting as UON. A 22-year-old male was transferred to our nephrology department due to azotemia. Sudden deterioration of his vision occurred 3 days before his transfer. The patient's blood pressure was 150/90 mmHg, and he had no symptoms or signs of uremia, except for the visual disturbance. Blood tests showed an elevated serum creatinine of 6.0 mg/dL and serum BUN of 53.6 mg/dL. Both kidneys were decreased in size on ultrasound. His best-corrected vision was 20/62.5 in both the eyes. Ophthalmoscopy revealed hyperemia, swelling of both optic nerve heads, and blurred margins of both optic disks. These findings are compatible with UON. The patient's visual acuity and visual field improved following hemodialysis and corticosteroid treatment. The swelling of the patient's optic disks was also resolved. The patient is currently undergoing hemodialysis with the goal of vision restoration. Uremic optic neuropathy should be considered when patients with advanced chronic kidney disease complain of deterioration of their vision.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Gyeongsang National University, Jinju City, Gyeongsangnam-do, South Korea.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Seo
authors.forename: Dae-Hong
authors.initials: DH
authors.lastname: Jeon
authors.forename: Yeojin
authors.initials: Y
authors.lastname: Kang
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.forename: Hyeon Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Woong Sun
authors.initials: WS
authors.lastname: Yoo
authors.forename: Hyun-Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Se-Ho
authors.initials: SH
authors.lastname: Chang
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Park
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D053099:Azotemia / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy; D001766:Blindness; D003404:Creatinine / Q000097:blood; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D009901:Optic Nerve Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006435:Renal Dialysis; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones; D003404:Creatinine