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Research Letter |

Subretinal Drusenoid Deposits Associated With Complement-Mediated IgA Nephropathy

David R. Lally, MD1; Caroline Baumal, MD1
[+] Author Affiliations
1Department of Ophthalmology, New England Eye Center, Vitreoretinal Service, Tufts University School of Medicine, Boston, Massachusetts
JAMA Ophthalmol. 2014;132(6):775-777. doi:10.1001/jamaophthalmol.2014.387.
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Complement-mediated IgA nephropathy is the most common cause of chronic glomerulonephritis worldwide. The pathogenesis of renal damage is related to complement activation secondary to IgA immune complex deposition in the glomerulus. To our knowledge, this is the first report of IgA nephropathy associated with bilateral subretinal drusenoid deposits (SDDs). A hypothesis for the role of complement is proposed.

Article InformationCorresponding Author: David R. Lally, MD, New England Eye Center, 260 Tremont St, Boston, MA 02116 (david.lally@gmail.com).

Author Contributions: Dr Lally had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Lally, Baumal.

Acquisition, analysis, or interpretation of data: Lally, Baumal.

Drafting of the manuscript: Lally, Baumal.

Critical revision of the manuscript for important intellectual content: Lally, Baumal.

Statistical analysis: Lally, Baumal.

Administrative, technical, or material support: Lally.

Study supervision: Baumal.

Conflict of Interest Disclosures: None reported.

Funding/Support: This work was supported in part by an unrestricted award to the New England Eye Center, Tufts University School of Medicine from Research to Prevent Blindness.

Role of the Sponsor: Research to Prevent Blindness was involved in the design and conduct of the study but had no role in collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Figure 1.
Fundus Photographs

Color fundus photographs of the right (A) and left (B) eyes show small, clustered, well-defined macular deposits with relative sparing of the central fovea.

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Figure 2.
Spectral-Domain Optical Coherence Tomographic Images

Spectral-domain optical coherence tomographic images of the right (A) and left (B) eyes showing focal hyperreflectivity internal to the retinal pigment epithelium–Bruch membrane (white arrowheads). B, There is a small elevation of the ellipsoid band that has slightly reduced reflectivity (black arrowhead). There is poorly defined granular hyperreflectivity adjacent to the focal deposits and internal to the retinal pigment epithelium–Bruch membrane. Insets, Magnified views of the spectral-domain optical coherence tomographic images.

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