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International Journal of Preclinical and Clinical Research

Article

International Journal of Preclinical and Clinical Research

Year: 2022, Volume: 3, Issue: 4, Pages: 90-92

Case Report

Bilateral Exudative Retinal Detachment Secondary to Malignant Hypertension – A Case Report

Received Date:30 November 2022, Accepted Date:12 December 2022, Published Date:28 December 2022

Abstract

To report a case of bilateral exudative retinal detachment secondary to malignant hypertension. Hypertension has been identified as a major cause of morbidity and mortality across the world. A 29-year-old female presented with sudden onset painless loss of vision in both eyes since a day. Known case of hypertension for 6 months on irregular medication. On examination vision of the right eye was hand movement with no pinhole improvement, and on left eye it was counting finger 2 meter with no pin hole improvement. Intraocular pressure of both eyes was normal. Anterior segment examination of right eye was normal except relative afferent pupillary defect. Anterior segment of left eye was normal. Fundus examination - Bilateral disc swelling with inferior retinal detachment extending 4 to 7 clock hours with flame shaped haemorrhages and cotton wool spots over blood vessels with AV crossings with dull foveal reflex. OCT showed bilateral exudative detachment of sensory retinaBP -150/100 mmhg. Further investigation found to have acute renal failure, requiring urgent dialysis, and patient was started on dialysis. 3weeks after blood control was acheived ,visual acquity improved to 6/18 BE with exudative retinal detachment in both eyes resolved by its own except with few residual haemorrhages. Accelerated HTN may precipitate bilateral exudative retinal detachment in patient with acute renal failure in young adults. Bilateral exudative retinal detachment is a catostropic event which results in devastating vision loss within very short time span. Timely intervention may save the vision loss and renal failure.

 

Keywords: Hypertensive retinopathy, Exudative retinal detachment, OCT

References

  1. Hammond S, Wells JR, Marcus DM, Prisant LM. Ophthalmoscopic Findings in Malignant HypertensionThe Journal of Clinical Hypertension2006;8(3):221223. Available from: https://doi.org/10.1111%2Fj.1524-6175.2005.04147.x
  2. Sánchez-Sevila JL, Martínez-Rubio M, López-Meca I, Belmonte-Martínez J. Exudative retinal detachment and primary pulmonary hypertensionArchivos de la Sociedad Española de Oftalmología (English Edition)2013;88(5):189192. Available from: https://doi.org/10.1016/j.oftale.2012.04.021
  3. Kinyoun JL, Kalina RE. Visual Loss from Choroidal IschemiaAmerican Journal of Ophthalmology1986;101(6):650656. Available from: https://doi.org/10.1016/0002-9394(86)90764-6
  4. Hirano Y, Yasukawa T, Ogura Y. Bilateral Serous Retinal Detachments Associated with Accelerated Hypertensive ChoroidopathyInternational Journal of Hypertension2010;2010:14. Available from: https://doi.org/10.4061%2F2010%2F964513
  5. Villalba-Pinto L, Hernández-Ortega MÁ, Mozos FJLDL, Pascual-Camps I, Dolz-Marco R, Arevalo JF, et al. Massive Bilateral Serous Retinal Detachment in a Case of Hypertensive ChorioretinopathyCase Reports in Ophthalmology1904;5(2):190194. Available from: https://doi.org/10.1159%2F000364942
  6. Read RW, Holland GN, Rao NA, Tabbara KF, Ohno S, Arellanes-Garcia L, et al. Revised diagnostic criteria for Vogt-Koyanagi- Harada disease: report of an international Committee on nomenclatureAm J Ophthalmol2001;131(5):647652. Available from: https://doi.org/10.1016/s0002-9394(01)00925-4
  7. Ugarte M, Horgan S, Rassam S, Leong T, Kon CH. Hypertensive choroidopathy: recognizing clinically significant end-organ damageActa Ophthalmologica2008;86(2):227228. Available from: https://doi.org/10.1111/j.1600-0420.2007.01030.x
  8. Shukla D, Ramchandani B, Vignesh TP, Rajendran A, Neelakantan N. Localized Serous Retinal Detachment of Macula as a Marker of Malignant HypertensionOphthalmic Surgery, Lasers and Imaging Retina2010;41(3):17. Available from: https://doi.org/10.3928/15428877-20100215-74
  9. Anand R, Tasman WS. Nonrhegmatogenous Retinal Detachment. In: Ryan SJ., ed. Retina. (pp. 2121-2141Elsevier. 2006.
  10. Day H, Burns J, Bosio P. A case of bilateral serous retinal detachments in severe pre-eclampsiaJournal of Obstetrics and Gynaecology2008;28(5):534535. Available from: https://doi.org/10.1080/01443610802234467
  11. Varghese S, Koshy J, Avasthi K. Bilateral serous retinal detachment in a case of eclampsiaHealth2012;4(1):1314.
  12. Malhotra SK, Gupta R, Sood S, Kaur L, Kochhar S. Bilateral renal Artery Stenosis Presenting As Hypertensive Retinopathy & ChoroidopathyIndian J Ophthalmol2002;50(3):221223. Available from: https://pubmed.ncbi.nlm.nih.gov/12355701/
  13. Pierro L, Pece A, Camesasca F, Brancato R. Hypertensive choroidopathy: a case reportInt Ophthalmol1991;15(1):914. Available from: https://doi.org/10.1007/bf00150973
  14. Liu DTL, Shields JA, Li CL, Ng HK, Lam DSC. Hypertensive choroidopathy in Castleman's diseaseGraefe's Archive for Clinical and Experimental Ophthalmology2011;249(12):19011903. Available from: https://doi.org/10.1007/s00417-011-1721-x
  15. Tranos PG, Wickremasinghe SS, Hundal KS, Foster PJ, Jagger J. Bilateral serous retinal detachment as a complication of HELLP syndromeEye2002;16(4):491492. Available from: https://doi.org/10.1038/sj.eye.6700056

Copyright

© 2022 Sheema & Prashanth. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Published By Basaveshwara Medical College & Hospital, Chitradurga, Karnataka

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