Sahay Pranita, Pandya Ishan, Maharana Prafulla Kumar, Titiyal Jeewan S
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
BMJ Case Rep. 2018 Jun 27;2018:bcr-2018-224545. doi: 10.1136/bcr-2018-224545.
A 25-year-old male patient presented with complaints of blurred vision in both eyes since 2 years. The patient was a known case of nephrotic syndrome with dyslipidaemia for which he was on diuretics and lipid-lowering agents for 3 years. On examination, his visual acuity was 6/9 in both eyes with cloudy cornea and arcus juvenilis. Fundus examination was within normal limits. On systemic work-up, his lipid profile was deranged with increased serum total cholesterol, very low density lipoprotein, low density lipoprotein and triglyceride. The serum high density lipoprotein was decreased. Renal function test revealed elevated serum creatinine with significant proteinuria. Renal biopsy was suggestive of dense deposit disease on immunofluorescence and transmission electron microscopy. Ocular manifestation of dense deposit disease is characterised by retinal drusen, pigmentary atrophy, choroidal neovascular membrane and atypical serous retinopathy. To the best of our knowledge, anterior segment changes in dense deposit disease has not been reported. This is the first case reporting cloudy cornea with arcus juvenilis in a case of dense deposit disease.
一名25岁男性患者自述双眼视力模糊已有2年。该患者为已知的肾病综合征伴血脂异常病例，为此他服用利尿剂和降脂药物3年。检查发现，他双眼视力为6/9，角膜混浊且有青年环。眼底检查正常。全身检查显示，他的血脂异常，血清总胆固醇、极低密度脂蛋白、低密度脂蛋白和甘油三酯升高。血清高密度脂蛋白降低。肾功能检查显示血清肌酐升高且有大量蛋白尿。肾活检在免疫荧光和透射电子显微镜检查下提示为致密物沉积病。致密物沉积病的眼部表现特征为视网膜玻璃膜疣、色素性萎缩、脉络膜新生血管膜和非典型性浆液性视网膜病变。据我们所知，尚未有关于致密物沉积病眼前节改变的报道。这是首例报告致密物沉积病患者出现角膜混浊和青年环的病例。
