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Kidney disease and eye changes
Last reviewed: 07.07.2025
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Chronic glomerulonephritis often causes changes in the retinal vessels - narrowing of the retinal arteries (renal antiopathy). With prolonged kidney disease, sclerotic changes occur in the vessel walls, and renal retinopathy develops in the retina. Renal retinopathy is characterized by narrowing of the retinal vessels and their sclerosis, there is retinal edema around the optic disc and in the central part of the fundus. In the macular region, multiple small foci form a star shape. Renal retinopathy may be complicated by hemorrhages or retinal detachment. If the kidney condition worsens, retinopathy may progress to the third stage - renal neuroretinopathy, in which the ophthalmoscopic picture resembles that of neuroretinopathy in patients with hypertension. The optic disc is edematous, its borders are unclear, the retina is edematous, there are hemorrhages in the area of the macula, and there are star-shaped foci of exudate. This is always a bad prognostic sign for the patient's life.
Kidney diseases, especially chronic glomerulonephritis, often cause changes in the retinal vessels. Even with a short duration of the disease, narrowing of the retinal arteries is noted, which is considered the beginning of the development of renal angiopathy. With a long course of the disease, sclerotic changes occur in the walls of the vessels, the retina is involved in the pathological process and renal retinopathy develops, the consequences of which are more severe than with hypertension.
In renal retinopathy, the retinal vessels are narrowed and moderately sclerosed, there is retinal edema around the optic disc and in the central part of the fundus. A large number of superficial flocculent white exudative foci are characteristic. In the macular region, multiple small foci form a star-shaped figure, which is characteristic of this pathology.
Renal retinopathy may be complicated by hemorrhages or retinal detachment, complete or partial. In acute glomerulonephritis, there are no such gross changes in the fundus and changes in the retina may undergo reverse development, although degenerative changes in both the retina and the optic nerve often persist.
If the kidney condition worsens, retinopathy can progress to stage III - renal neuroretinopathy, in which the ophthalmoscopic picture resembles that of neuroretinopathy in patients with hypertension. The optic disc is edematous, its borders are unclear, retinal edema, hemorrhages are observed, foci of exudate are almost always located in the area of the macula in the form of a star. This is always a bad prognostic sign for the patient's life.
Changes in the macula in the form of a star may appear after acute infections - flu, meningitis, measles, tuberculosis, syphilis, as well as focal infections. In such cases, pathological changes in the retina are reversible.
Treatment is carried out in conjunction with a nephrologist. Locally, agents are used to strengthen the vascular wall (dicynone, prodectin) and improve trophic processes (ATP, vitamins A, B, C).
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