Post-transplant erythrocytosis-related maculopathy: successful management of hyperviscosity with phlebotomy.

OBJECTIVE

To report clinical features in a case of hyperviscosity retinopathy following post-renal transplant erythrocytosis (PTE) and its outcome after phlebotomy.

METHODS

Fundus fluorescein angiography and optical coherence tomography (OCT) were carried out for a 29-year-old renal allograft recipient who presented with acute unilateral visual loss.

RESULTS

There was mild retinal vascular dilation in both eyes with retinal hemorrhages and retinal opaqueness in left eye. Cystoid macular edema was noted on OCT. Microvascular leaks and micro-occlusions were seen all around the foveal avascular zone on fluorescein angiogram. Investigations revealed hemoglobin to be 16.8 g%, and a PTE was diagnosed. The patient underwent phlebotomy following which there was near complete resolution of macular edema with improvement in vision.

CONCLUSIONS

Hyperviscosity retinopathy can cause acute visual loss in cases of renal allograft recipients who develop PTE. Prompt management with phlebotomy can lead to reversal of macular edema in such cases.