Abstract

PURPOSE: To describe the case of a 24-year-old male with transplant-associated retinal thrombotic microangiopathy (TMA) secondary to hemodynamic instability following renal transplant. METHOD AND RESULTS: Fundus examination showed vitreous cells with cotton wool spots and macular edema with peri-arteriolar sparing. Structural OCT showed sub-retinal fluid with intra-retinal cystoid edema. FFA showed background choroidal hypo-fluorescence with multiple pin-point hyper-fluorescent leaks in the late phase with increased FAZ suggestive of macular ischemia. Blood reports were positive for cytomegalovirus (CMV). Presenting symptoms and ocular findings were consistent with purtscher-like retinopathy and viral retinitis. CONCLUSION: Post renal transplantation retinal changes may either be the deterioration of pre-existing retinal diseases or represent complications of the procedure or the treatment started in the postoperative period giving rise to a mixed retinopathy picture.