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V. Silvestri, K. Megaw, E. Moore, C. McAvoy, G. S. Hageman, G. Silvestri; Progression of Retinal Changes in Membranoproliferative Glomerulonephritis Type II. Invest. Ophthalmol. Vis. Sci. 2009;50(13):253.
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Membranoproliferative Glomerulonephritis Type II (MPGNII) is known to cause drusen formation similar to those found in age-related macular degeneration (AMD). The purpose of this study is to review the fundal appearance of a cohort of MPGNII patients to determine if a particular pattern of distribution of drusen and progression is present in these patients.
Nineteen patients are known to have MPGNII in Northern Ireland, population 1.7 million. All patients were invited to attend for visual assessment and retinal imaging. Those patients who were unable to attend hospital were offered a home visit where colour fundus photography was carried out and venous blood sampling was taken for DNA, serum and plasma analysis. Retinal photography in hospital was carried out using a Topcon TRC 50DX fundus camera and photography at home visits was carried out using the Canon CR-DGi non-mydriatic camera. Where previous images were available from hospital records an assessment of progression was made. Five patients who had MPGN for 1-5 years, 5-10, 11-15,15-20 and > 25 years also had detailed retinal imaging with Fourier Domain OCT and Autofluorescence using the Heidelberg Spectralis.
Results are available for 13 participants. The retinal phenotype appears to follow the following pattern of progression:
OCT scanning at 1 year disease duration shows that Bruch’s membrane and the RPE remain healthy. With advancing disease there is progressive disruption of the Bruch’s membrane and the RPE. In advanced disease before the onset of choroidal neovascularization, the inner retina retains its normal architecture.
The retinal phenotype in MPGNII does appear to follow a distinct phenotypic progression. We propose a 6 stage classification for MPGNII retinopathy.
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