Rev Bras Oftalmol.2025;84:e0011
Chronic kidney disease and retinal manifestations and repercussions
DOI: 10.37039/1982.8551.2025.0011
ABSTRACT
The objective of this study was to report a case of bilateral hypertensive retinopathy in a female child with chronic renal disease caused by focal segmental glomerulosclerosis, highlighting an exceptional presentation in this age group and reviewing its treatment and challenges. An 18-year-old female with a history of focal segmental glomerulosclerosis presented with progressive loss of vision. Ophthalmological examination of the right eye revealed a bilateral visual acuity of 20/400. Fundoscopic examination showed peripapillary retinal flame hemorrhage in the inferior temporal quadrant, central vessel emergency, a normal neural ring, and cotton wool exudates in the 180° perimacular region extending two-disc diameters from the fovea, with adjacent macular edema. A diagnosis of bilateral severe hypertensive retinopathy was made, and the patient was deferred for urgent metabolic control. Treating patients with hypertensive retinopathy is challenging when metabolic control affects ocular vasculature. Here, we present an exceptional case of a female child with advanced bilateral hypertensive retinopathy caused by severe focal segmental glomerulosclerosis.
