Optical coherence tomography angiography findings in malignant hypertensive retinopathy

Arq Bras Oftalmol. 2019 Jan-Feb;82(1):72-77. doi: 10.5935/0004-2749.20190015.

Abstract

A 33-year-old male presented to our clinic with low vision in both eyes that started during the previous week. Visual acuity was 20/63 in the right eye and 20/50 in the left eye. Fundus examination revealed signs of hypertensive retinopathy; thus, a multidisciplinary approach was adopted for the diagnosis and treatment of this patient. We consulted the nephrology and cardiology departments on this case. Upon diagnosing malignant hypertension and renal failure, the patient was put on hemodialysis. His visual acuity was 20/20 at 6 months, whereas foveal assessment on optical coherence tomography angiography revealed neither marked superficial and deep capillary density loss and foveal avascular zone enlargement nor a decrease in disc flow and radial peripapillary capillary density. Early diagnosis and treatment of malignant hypertension are critical in preventing progression of end-organ damage including the eyes. Optical coherence tomography angiography may be useful in cases when fundus fluorescein angiography is relatively contraindicated (e.g., renal failure).

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Angiography / methods*
  • Capillaries / diagnostic imaging
  • Capillaries / pathology
  • Disease Progression
  • Humans
  • Hypertension, Malignant / diagnostic imaging*
  • Hypertension, Malignant / pathology
  • Hypertensive Retinopathy / diagnostic imaging*
  • Hypertensive Retinopathy / pathology
  • Male
  • Renal Insufficiency, Chronic
  • Retinal Vessels / diagnostic imaging
  • Retinal Vessels / pathology
  • Time Factors
  • Tomography, Optical Coherence / methods*