Multimodal Imaging of Elschnig Spots: A Case of Simultaneous Hypertensive Retinopathy, Choroidopathy, and Neuropathy

ABSTRACT A 65-year-old woman with chronic hypertension, chronic renal insufficiency, and schizophrenia self-discontinued her medications and presented complaining of decreased vision; she was found to have a blood pressure of 256/156 and visual acuity 20/70 OD. In the emergency department, her blood pressure was rapidly lowered to a nadir of 134/104. During the course of her hospitalization, her visual acuity declined from 20/70 to 20/200 OD in parallel with a decline in her renal function. Multi-modal imaging revealed simultaneous hypertensive retinopathy, choroidopathy, and optic neuropathy. Autofluorescence can play an important role in the diagnosis of hypertensive choroidopathy.

[1]  R. Amer,et al.  Elschnig's Spots in the Acute and Remission Stages in Preeclampsia: Spectral-Domain Optical Coherence Tomographic Features , 2015, European journal of ophthalmology.

[2]  B. Palmer.  Renal dysfunction complicating the treatment of hypertension. , 2002, The New England journal of medicine.

[3]  S. Hayreh.  Classification of hypertensive fundus changes and their order of appearance. , 1989, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde.

[4]  I. Wallow,et al.  The eye in accelerated hypertension. I. Elschnig's spots in nonhuman primates. , 1980, Archives of ophthalmology.

[5]  M. Tso.  Axoplasmic transport in papilledema and glaucoma. , 1977, Transactions. Section on Ophthalmology. American Academy of Ophthalmology and Otolaryngology.

[6]  A. Harnish,et al.  EVOLUTION OF HYPERTENSIVE RETINAL VASCULAR DISEASE: CORRELATION BETWEEN CLINICAL AND POSTMORTEM OBSERVATIONS , 1973, Medicine.