Vision Impairment After Iron Chelating Agent in a Patient Under Peritoneal Dialysis

Abstract

A 54-year-old female patient had a history of end-stage renal disease (ESRD) under continuous automatic peritoneal dialysis (CAPD) therapy for 6 years. She had underlying hypertension history under oral hypertensives (olmesartan medoxomil). She was admitted to the ward for iron chelating agent therapy due to high ferritin level (5480 ng/ml). Deferoxamine 1 gram was prescribed with intravenous drip for 24 hours for 5 days. On the fifth day, she complained about vision problems, i.e. central halo pattern vision loss. A deferoxamine-related macula edema was diagnosed. After discontinuing the medication, her vision gradually improved. After 3 months of follow up, her vision disorders recovered.Although we reduced the dose of iron chelating agent, vision side effects also occurred in this ESRD patient.This case taught us to perform a careful detection of vision problems before, during, and after deferoxamine therapy in order to prevent irreversible vision disorders.