Unilateral hypertensive choroidopathy as a sole manifestation in malignant hypertension: optical coherence tomography angiography findings-case report

BMC Ophthalmology

Case Report

Stylianos Kandarakis¹  Efstratios Paroikakis²  Panagiotis Pantazis²  Loukas Kontomichos²  Nikolaos Bouratzis²  Dimitrios Karagiannis² 

[1] Department of Ophthalmology, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital, Athens, Greece;Second Department of Ophthalmology, Ophthalmiatreion Eye Hospital of Athens, Athens, Greece;

关键词: Malignant hypertension;    Hypertensive choroidopathy;    OCT-angiography;    Exudative retinal detachment;    Choriocapillaris;   

DOI  :  10.1186/s12886-023-02970-w

 received in 2022-09-18, accepted in 2023-05-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe present a case of hypertensive choroidopathy due to malignant hypertension with exudative retinal detachment as a sole finding. We use OCT- angiography for initial diagnosis and report findings from extensive follow up.Case presentationA 51-year-old female with no past medical history, presented to our clinic with painless loss of vision in her left eye. Fundus examination revealed only exudative retinal detachment in her left eye that was confirmed with Optical Coherence Tomography. Fluorescein angiography showed hyperfluorescent spots with leakage in late phases. OCTA manifested a focal dark area in the choriocapillaris slab corresponding to flow signal voids, signifying regions of non-perfusion. Her blood pressure was 220/120 mmHG. Complete blood work -up failed to reveal any other possible etiology. During follow-up period of 9 months blood pressure normalized, patient regained visual function and choriocapillaris perfusion was completely restored.Discussions and conclusionsHypertensive choroidopathy with exudative retinal detachment can be the only sign of malignant hypertension and no pre-existing history of a systemic disease is required in order to become apparent. OCTA reveals areas of non-perfusion at choriocapillaris level, proving that it is an essential tool in the diagnosis and follow up of patients with hypertensive choroidopathy. Finally, we propose that early diagnosis prevents permanent damage of the RPE and leads to complete choroidal remodeling and better visual outcomes.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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