Ehrhardt J, Gelisken F
Universitäts-Augenklinik Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland.
Ophthalmologe. 2018 Mar;115(3):222-225. doi: 10.1007/s00347-017-0492-0.
We report on a 30-year-old male patient presenting with acute bilateral loss of vision. Fundus examination showed bilateral retinal hemorrhages, cotton-wool spots, macular edema and optic disk hyperemia. The blood pressure was elevated. The patient was referred to the emergency department with the diagnosis of severe stage IV hypertensive retinopathy. Further examination revealed a previously unknown IgA glomerulonephritis with terminal renal failure and secondary blood pressure derailment. Hypertensive retinopathy can be a first sign of acute renal failure. In cases of hypertensive retinopathy the differential diagnosis including systematic screening is of utmost importance.
我们报告了一名30岁男性患者,其出现急性双侧视力丧失。眼底检查显示双侧视网膜出血、棉絮斑、黄斑水肿和视盘充血。血压升高。该患者被转诊至急诊科,诊断为重度IV期高血压性视网膜病变。进一步检查发现了先前未知的IgA肾小球肾炎伴终末期肾衰竭和继发性血压紊乱。高血压性视网膜病变可能是急性肾衰竭的首发症状。对于高血压性视网膜病变患者,包括系统筛查在内的鉴别诊断至关重要。