A Novel Case Study of Unilateral Serous Retinal Detachment in a Glaucoma Patient with Nephrotic Syndrome.

Purpose: To present a case of a unilateral serous retinal detachment in a patient with nephrotic syndrome following Ahmed valve implantation.

Methods: Retrospective descriptive case report.

Results: A 63-year-old male with a history of Ahmed valve implantation, diabetes, and hypertension presented with progressive corneal edema and decreased vison who developed a serous retinal detachment in the right eye. There was no view of the fundus due to the massive retinal detachment. B-scan ultrasound revealed a serous retinal detachment with mild choroidal thickening. Along with the development of anasarca, laboratory testing revealed significant proteinuria and hypoalbuminemia, consistent with nephrotic syndrome. Fluid restriction and treatment with diuretics and anti-hypertensives resulted in rapid resolution of the serous retinal detachment.

Conclusions: Though nephrotic syndrome can cause central serous retinal detachment, the presentation is almost always bilateral. A unilateral serous retinal detachment presentation can occur in patients with risk factors such as a history of Ahmed valve implantation and conditions that alter intravascular fluid hydrostatic and oncotic pressures. Prompt recognition of nephrotic syndrome in patients with kidney disease who develop serous retinal detachment is critical. Early treatment with diuretic therapy can significantly resolve ocular complications and potentially improve patient outcomes.