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A case of acute renal failure with fundus findings suggestive of cholesterol crystal embolism Tadashi Mine 1,2 , Shuichi Rikitake 3 , Hiroshi Enaida 1 1Department of Ophthalmology, Saga University Faculty of Medicine 2Department of Ophthalmology, Saga-Ken Medical Centre Koseikan 3Department of Nephrology, Saga-Ken Medical Centre Koseikan pp.1575-1578
Published Date 2017/10/15
DOI https://doi.org/10.11477/mf.1410212441
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Abstract Purpose:To report a case of acute renal failure who showed findings of cholesterol crystal embolism in the fundus.

Case:A 79-year-old male female received stent-graft surgery for abdominal aortic aneurysm. She developed acute renal failure with serum creatinine level of 3.1 mg/dl one month later. She was referred to us for detailed study.

Findings and Clinical Course:Corrected visual acuity was 1.2 in either eye. The right eye showed two sites of arterial embolism. Fluorescein angiography showed patent blood flow. Visual field was not affected. Echography showed narrowing in the right inner carotid artery. Both eyes developed embolism in the retinal artery 2 weeks later, leading to the diagnosis of cholesterol crystal embolism. Renal biopsy showed renal sclerosis as the sole pathological finding. Serum creatinine level decreased to 1.1 mg/dl 3 months later. There has been no incidence of retinal arterial embolism thereafter.

Conclusion:The present case was diagnosed with cholesterol crystal embolism. Funduscopy was useful in the diagnosis.


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