Swept Source Optical Coherence Tomography Evaluation of Chorioretinal Changes in Hypertensive Choroidopathy Related to Hellp Syndrome

Velázquez-Villoria, Daniel; Rodrigo, Pablo Marti; DeNicola, Maria L.; Zapata, Miguel Á.; García, Antonio Segura; García‐Arumí, José

doi:10.1097/icb.0000000000000524

Cited by 17 publications

(12 citation statements)

References 7 publications

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“…Swept source optical coherence tomography (SS-OCT) allows deeper penetration into the tissues; one study reported an increase in choroidal thickness in the acute phase of hypertensive choroidopathy. 9 SS-OCT angiography may reveal a motheaten appearance of the choriocapillaris, signifying areas of choroidal nonperfusion. 10 Reperfusion of the choriocapillaris may be seen after antihypertensive treatment is initiated.…”

Section: Diagnosis Of Hypertensive Chorioretinopathymentioning

confidence: 99%

<p>A Review of Hypertensive Retinopathy and Chorioretinopathy</p>

Tsukikawa¹,

Stacey²

2020

OPTO

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Hypertensive retinopathy and choroidopathy have important short-and long-term implications on patients' overall health and mortality. Eye care professionals should be familiar with the severity staging of these entities and be able to readily recognize and refer patients who are in need of systemic blood pressure control. This paper will review the diagnosis, staging, treatment, and long-term implications for vision and mortality of patients with hypertensive retinopathy and choroidopathy.

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Section: Diagnosis Of Hypertensive Chorioretinopathymentioning

confidence: 99%

<p>A Review of Hypertensive Retinopathy and Chorioretinopathy</p>

Tsukikawa¹,

Stacey²

2020

OPTO

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“…Hypertensive choroidopathy, however, has been reported in toxemia of pregnancy, renal disease and malignant hypertension. 9,10 In view of the temporal onset of clinical manifestation and symptoms and the absence of thrombotic microangiopathy, in our opinion, the bilateral serous retinal detachment observed in our patient was secondary to the acute hypertension rather than the pathology itself or any of the medications used. At the same time, we could not find evidence either in the drug safety information provided by the manufacturers or in the literature, that the medications used in this case are completely safe and could not have aggravated the acute condition caused by poor hypertensive control in this patient.…”

Section: Discussionmentioning

confidence: 46%

Hypertensive choroidopathy in atypical hemolytic-uremic syndrome

Polito

Machetta

Fea

et al. 2019

European Journal of Ophthalmology

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Purpose: We present the case of a 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome with a hypertensive crisis, who presented a bilateral serous retinal detachment. Case Description: A 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome, was referred for blurred vision in both eyes, evolving over 7 days. Treatment including hemodialysis, plasma exchange, systemic steroids, antihypertensive medications and eculizumab was started 1 month prior to referral. At presentation, best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye. Retinal examination revealed bilateral serous retinal detachment in the posterior pole and some small, flat, variably pigmented lesions. Optical coherence tomography confirmed marked serous retinal detachment in both eyes. Fluorescein and indocyanine green angiography was performed. Treatment for systemic hypertension was changed. Seven days later, dilated fundus examination and optical coherence tomography demonstrated a significant regression of the serous retinal detachment. Her visual acuity improves in both eyes at the last control, showing at fundus examination a complete resolution of the exudative detachment but a persistence of variable flat pigmented lesion. Conclusion: Although multiple organ systems are commonly affected in hemolytic uremic syndrome, ocular involvement has only been described in very few cases. Ocular manifestations in atypical hemolytic uremic syndrome include retinal, choroidal and vitreal hemorrhages, retina and/or ischemic signs. Bilateral serous retinal detachment may also be a sign of atypical hemolytic uremic syndrome or even the first manifestation of a hypertensive event.

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“…Subfoveal choroidal thickness was reported to be increased in acute hypertension due to accumulation of interstitial fluid as a result of hypertensive choroidopathy. [ 30 ] Acute rise in blood pressure may cause breakdown of autoregulatory mechanism, leading to choroidal ischemia with subsequent choriocapillaris and RPE necrosis. [ 31 ] This in turn leads to increased permeability of choriocapillaris and interstitial fluid accumulation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of choroidal thickness in systemic hypertensive subjects with healthy individuals by spectral domain optical coherence tomography

Waghamare

Mittal

Pathania

et al. 2021

Indian Journal of Ophthalmology

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Purpose: The purpose of the study was to compare the choroidal thickness in normal population and hypertensive patients and to assess the possible effect of hypertension on choroidal thickness using Spectral Domain Optical Coherence Tomography (SD-OCT). Methods: This was a comparative cross-sectional study. A total of 68 eyes of 34 individuals in the age group of 40–60 years were included in both the hypertensive group and control group. Individuals with refractive error beyond ± 3 D and posterior segment pathology were excluded. The choroidal thickness was measured at the sub-foveal region, 500 μm nasal and 500 μm temporal to the fovea on SD-OCT with enhanced depth imaging (EDI) mode. Systolic blood pressure (SBP), Diastolic blood pressure (DBP), and Mean arterial pressure (MAP) were recorded in all individuals. Duration of hypertension was also noted in hypertensive individuals. Results: The choroidal thickness at all locations was significantly lower in the hypertensive group (subfoveal, nasal, temporal and mean choroidal thickness 253.24 ± 63.96 μm, 249.35 ± 63.57 μm, 250.01 ± 63.37 μm, 250.87 ± 63.38 μm, respectively) as compared to the control group (subfoveal, nasal, temporal and mean choroidal thickness 301.25 ± 55.79 μm, 298.97 ± 57.07 μm, 299.49 ± 55.06 μm, 299.90 ± 55.50 μm, respectively). The choroidal thickness in the hypertensive group also had a significant negative correlation with the SBP (Spearman correlation coefficient, rho = –0.35, P = 0.003) and the duration of hypertension (rho = -0.25, P = 0.037). Conclusion: The study demonstrated decreased choroidal thickness in systemic hypertensive subjects as compared to age-matched healthy individuals. The choroidal thickness in hypertensive subjects also had a significant but weak negative correlation with SBP and duration of hypertension.

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Swept Source Optical Coherence Tomography Evaluation of Chorioretinal Changes in Hypertensive Choroidopathy Related to Hellp Syndrome

Cited by 17 publications

References 7 publications

<p>A Review of Hypertensive Retinopathy and Chorioretinopathy</p>

<p>A Review of Hypertensive Retinopathy and Chorioretinopathy</p>

Hypertensive choroidopathy in atypical hemolytic-uremic syndrome

Comparison of choroidal thickness in systemic hypertensive subjects with healthy individuals by spectral domain optical coherence tomography

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