Bilateral bullous exudative retinal detachment in renal failure

Bilateral bullous exudative retinal detachment has been reported in patients with renal failure, but the etiology and appropriate treatment at this type of retinal detachment are debatable. We present our experience with a patient with renal failure and bilateral bullous exudative retinal detachment. His renal disease was membrano-proliferative glomerulonephritis, which is immunologically mediated. The etiology of exudative retinal detachment associated with renal failure is discussed, and the roles of hypertension, fluid retention, electrolyte imbalance and immune-complex deposition in the presence and resolution of exudative retinal detachment in the patient are investigated. Clinical study indicated that immune-complex deposition or hypertension or both might have been the cause of retinal detachment in this patient. The resolution of retinal detachment was correlated with correction of fluid retention and dilutional hyponatremia, but unrelated to the level of blood pressure. The effect of systemic corticosteroid therapy remains unclear.