Proliferative Hypertensive Retinopathy in Secondary Arterial Hypertension
DOI:
https://doi.org/10.48560/rspo.35981Keywords:
Hypertension/complications, Hypertensive Retinopathy/diagnosis, Hypertensive Retinopathy/drug therapy, Retinal NeovascularizationAbstract
A 48-year-old Caucasian male presented in the emergency department complaining of right eye floaters. Ophthalmologic evaluation suggested bilateral proliferative retinopathy with vitreous hemorrhage in the right eye. Blood pressure was found to be 210/110 mmHg, and severe hypertensive retinopathy was suspected.
A fluorescein angiography revealed bilateral areas of macular and peripheral retinal ischemia and retinal neovascularization in the right eye. On spectral domain optical coherence tomography, bilateral macular edema was present.
Management included bilateral targeted retinal photocoagulation in non-perfused areas and intravitreal bevacizumab injections in the right eye. A diagnosis of primary hyperaldosteronism was made after systemic investigation.
During follow-up, both clinical and angiographic improvement were observed. Retinal neovascularization is a rare complication of severe hypertensive retinopathy, for which treatment with laser photocoagulation and intravitreal anti-angiogenic agents can be undertaken. The potentially devastating effects of retinal neovascularization highlight the need for prompt ophthalmologic evaluation along with extensive multidisciplinary investigation.
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