Flecked retina. Appearance secondary to oxalate crystals from methoxyflurane anesthesia
J. D. Bullock and D. M. Albert
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 ayndrome. 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
cillary epithelium.
