American Journal of Ophthalmology Case Reports (Sep 2022)

C3 glomerulopathy associated with both hypertensive retinopathy and purtscher-like retinopathy

  • Moosa Zaidi,
  • Kapil Mishra,
  • Huy Vu Nguyen,
  • Paul Peter Miller,
  • Hashem Ghoraba,
  • Irmak Karaca,
  • Wataru Matsumiya,
  • Quan Dong Nguyen,
  • Loh-Shan Bryan Leung

Journal volume & issue
Vol. 27
p. 101683

Abstract

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Purpose: This article reports the case of a 21-year-old woman with both hypertensive retinopathy and Purtscher-like retinopathy in association with C3 glomerulopathy. Observations: The patient was referred for bilateral painless vision loss with posterior pole cotton wool spots, optic disc edema, and confluent retinal whitening suggesting a mixed picture of hypertensive retinopathy, with initial blood pressure 236/152, and Purtscher-like retinopathy. She was subsequently diagnosed with C3 glomerulopathy which likely caused her severe hypertension and which likely occurred alongside Purtscher-like retinopathy due to a shared pathogenesis of complement dysregulation. Follow up examination and imaging revealed gradual improvement in visual acuity, almost complete resolution of fundus exam abnormalities, improvement in macular nonperfusion, resolution of disc leakage and choroidal leakage, resolution of macular edema, and residual outer retinal hyperreflective foci in both eyes. Conclusion and importance: This case represents the first report of both Purtscher-like retinopathy and hypertensive retinopathy occurring in association with C3 glomerulopathy. It supports investigation of anti-complement therapy as a potential treatment for Purtscher-like retinopathy.

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