Longitudinal Optical Coherence Tomography Angiography Findings in Malignant Hypertension Choroidopathy: A Case Report

Viruni, Narine; Ong, Sally S.; Wu, Jo‐Hsuan; Liu, T.Y. Alvin

doi:10.1159/000524115

Cited by 2 publications

(2 citation statements)

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“…Our findings were similar to the patients described by Mirshahi et al [ 7 ] who described similar patterns of capillary dropout within the superficial and deep retinal plexus, and Viruni et al [ 11 ] who described a similar capillary dropout within the retinal capillary plexus in association with choriocapillaris flow voids. Unlike the cases described by Rotsos and co-workers [ 8 ], we could not detect any hyperreflective lesions within the choriocapillaris.…”

Section: Discussionsupporting

confidence: 92%

“…At a three-monthly follow-up, her visual acuity improved with a reduction in the flow voids of the choriocapillaris but the capillary nonperfusion of the retinal plexus was unchanged. The authors suggest that hypertension-induced fibrinoid necrosis of choroidal arterioles with a breakdown of the blood-retinal barrier may account for these changes [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Optical Coherence Tomography Angiography Findings Associated With Accelerated Hypertension

Mehta

2024

Cureus

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Introduction Accelerated hypertension, that is a systolic blood pressure greater than 180 mmHg and a diastolic blood pressure greater than 120 mmHg is often accompanied by fundoscopic signs with the potential of systemic and visual morbidity. We report on the clinical and optical coherence tomography angiography (OCTA) findings in a cohort of hypertensive patients with accelerated hypertension. Methods Patients, presenting to the emergency room/intensive care unit, who met the clinical definition of accelerated hypertension (a blood pressure >180/120 mmHg,), were triaged to the intensive care unit. Following blood pressure reduction via pharmacological methods, a standard panel of hematological tests, cardiac evaluation tests, and the necessary systemic imaging was performed. They underwent a bedside dilated fundus examination with subsequent fundus photography/OCTA using a Topcon DRI OCT plus (Topcon Corporation, Tokyo, Japan). The records of these patients were evaluated. Results We analyzed the records of 16 patients (12 males (75%), and four females (25%)) with ages ranging from 16 to 75 years (mean 47.6 years). Eleven patients consented to a detailed evaluation. These included nine males (81.8%) and two females (18.1%) with ages ranging from 16 to 63 years (mean 46.3 years). Comorbidities included pre-existing hypertension (nine patients, 81.8%), chronic kidney disease (three patients, 27.2%), and diabetes mellitus type 2 (two patients, 18.1%). Clinical findings in these 22 eyes included arteriolar changes consistent with Keith Wagener Barker (KWB) grade 1 (two eyes, 9.0%), grade 2 (10 eyes, 45.4%), grade 3 (eight eyes, 36.3%), and grade 4 (two eyes, 9.0%). OCTA findings included capillary nonperfusion in the superficial capillary plexus in the areas of retinal opacification (seven eyes, 31.8%). Conclusion OCTA studies of the macular, as well as the entire posterior pole vasculature, may help to detect retinal microangiopathy, permit accurate grading, and subsequently develop a model that permits the quantification of systemic and ocular risk in these patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%