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Appearance Secondary to Oxalate Crystals From Methoxyflurane Anesthesia

John D. Bullock, MD; Daniel M. Albert, MD

Arch Ophthalmol. 1975;93(1):26-31.

Abstract
Calcium oxalate crystals were demonstrated in the retinal pigment epithelium (RPE) of a 66-year-old white man with changes in the fundus oculi consistent with the flecked retina syndrome. The patient had a history of rheumatoid arthritis, mild hypertension, and mild renal insufficiency presumed due to his hypertension. He underwent prolonged abdominal surgery under methoxyflurane anesthesia, following which he developed acute irreversible renal failure. Calcium oxalate crystals were demonstrated postoperatively in a kidney biopsy specimen. He subsequently was maintained on renal dialysis with decreasing renal function. Several weeks before his death fundus examination revealed a picture suggestive of a flecked retina syndrome. At autopsy, widespread oxalosis was found including crystals in the RPE and in some areas in the neural retina and ciliary epithelium.

Author Affiliations
From the Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Conn.

Footnotes
Submitted for publication July 25, 1973.

Read before the New England Ophthalmological Society, Massachusetts Eye and Ear Alumni Association meeting, Boston, June 23, 1973.

Reprint requests to 2323 Sharon Rd, Townhouse 119, Menlo Park, CA 94025 (Dr. Bullock).

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