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      Spontaneous Resolution of Retinal Pigment Epithelial Detachments and Visual Improvement in Patient with MPGN II: A Case Report

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          Abstract

          A 31-year-old female suffering from membranoproliferative glomerulonephritis type II (MPGN II) presented to the Eye Casualty Department reporting a history of blurred and distorted vision. The patient appeared to have drusenoid retinal epithelial detachments and minimal intraretinal fluid. The subretinal deposits, basal lamina drusen, and pigment epithelial detachment appeared to resemble a “stars in the sky” picture with no symmetry between the eyes. The retinal pigment epithelial detachments improved and flattened over 18 month. and the best corrected visual acuity improved in the most affected eye. There was no evidence of neovascularization, and the intraretinal fluid disappeared spontaneously.

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          Fundus changes in (type II) mesangiocapillary glomerulonephritis simulating drusen: a histopathological report.

          C. M. Macdonald, Ken H. Young, N McKechnie (1989)
          We report for the first time to our knowledge the histopathological findings in the eye of a patient with type II mesangiocapillary glomerulonephritis (dense deposit disease) in which a deposit of material morphologically very similar to that which is pathognomonic for the disease in the kidney was demonstrated in Bruch's membrane. The nature of the deposit in the renal lesion is unknown but is considered to represent a structural alteration secondary to a reaction with anticomplement antibody. Clinically the fundus appearance resembled that seen in drusen.
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            Retinal changes associated with type 2 glomerulonephritis.

            G Silvestri, Norma C. McAvoy (2005)
            The aims of this study were to: Investigate retinal changes associated with type 2 membranoproliferative glomerulonephritis (type 2 MPGN). Assess whether there was a relationship between the severity of the kidney disease and ophthalmoscopically visible fundal changes. Find out if renal transplantation was linked with visual deterioration. Decide if patients with type 2 MPGN need to be referred for ophthalmological assessment. The patients were identified from pathology department records as having renal biopsy proven type 2 MPGN from January 1981 to October 2003. Patients were invited to attend for ophthalmic assessment. A total of 26 biopsy proven cases of type 2 MPGN were identified. One patient lost vision from a possible occult choroidal neovascular membrane. The extent of ocular involvement did not consistently appear to be related to the severity of the renal involvement, although there was a relationship between the presence of ocular lesions and the duration of the disease. The longer the disease was present the more likely the patients were to have ophthalmoscopically visible fundal changes. Renal transplantation did not appear to have a detrimental effect on vision with the possible exception of one patient. Referral of type 2 MPGN patients by the renal physician for an initial ophthalmological assessment may be beneficial so that symptoms of choroidal neovascularization can be explained and patients advised to seek urgent help if distortion of central vision occurs. Renal transplantation does not appear to be a risk factor for the development of choroidal neovascular membranes.
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              Membranoproliferative glomerulonephritis type II associated with central serous retinopathy.

              M Ulbig, Daniel P. Riordan, Frank G. Holz … (1993)
              Membranoproliferative glomerulonephritis type II is specifically associated with the presence of dense deposits in the basement membrane of Bruch's membrane, which result in lesions similar to basal laminar drusen, exudative drusen, and retinal pigment epithelial detachments. In advanced stages of this dense-deposit retinopathy, choroidal neovascularization may occur. We observed a 36-year-old patient with membranoproliferative glomerulonephritis type II who developed central serous retinopathy in the presence of specific dense-deposit-associated fundus lesions. The diffuse drusenlike dense deposits (at the level of Bruch's membrane) and associated retinal pigment epithelial detachments appear to contribute to the pathogenesis of central serous retinopathy. Thus changes in Bruch's membrane may be involved in the development of central serous retinopathy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Ophthalmol Med
                Journal ID (iso-abbrev): Case Rep Ophthalmol Med
                Journal ID (publisher-id): CRIM.OPHMED
                Title: Case Reports in Ophthalmological Medicine
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-6722
                ISSN (Electronic): 2090-6730
                Publication date (Print): 2012
                Publication date (Electronic): 5 December 2012
                Volume: 2012
                Electronic Location Identifier: 864198
                Affiliations
                Ophthalmology Department, Leicester Royal Infirmary, University Hospitals of Leicester, Leicester LE15WW, UK
                Author notes

                Academic Editors: J. F. Arevalo, A. Ferreras, and M. B. Parodi

                Article
                DOI: 10.1155/2012/864198
                PMC ID: 3521410
                PubMed ID: 23259099
                SO-VID: 83ac6366-1a1d-460c-8068-509c2c0efc88
                Copyright © Copyright © 2012 T. Empeslidis et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 26 September 2012
                Date accepted : 8 November 2012
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Ophthalmology & Optometry
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry

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