Purpose: To describe an atypical presentation of vitreous inflammation in a patient with malignant hypertension. Methods: A case was evaluated. Results: A patient presenting with a hypertensive emergency was found to have decreased vision in the setting of severe optic nerve head edema, extensive hard exudates, cotton-wool spots, and Elschnig spots in both eyes secondary to malignant hypertension as well as vitreous cells bilaterally. He was admitted to the pediatric intensive care unit for intravenous medications and observation. Conclusions: This case adds to the growing body of evidence suggesting that hypertensive urgency may be accompanied by inflammation.
Centers for Disease Control and Prevention (CDC). Hypertension cascade: hypertension prevalence, treatment and control estimates among US adults aged 18 years and older applying the criteria from the American College of Cardiology and American Heart Association’s 2017 hypertension guideline—NHANES 2015–2018. US Department of Health and Human Services; 2021.
2.
MillsKTStefanescuAHeJ.The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-237. doi:10.1038/s41581-019-0244-2
3.
Di MarcoEAielloFLombardoM, et al. A literature review of hypertensive retinopathy: systemic correlations and new technologies. Eur Rev Med Pharmacol Sci. 2022;26(18):6424-6443. doi:10.26355/eurrev_202209_29742
4.
TsukikawaMStaceyAW.A review of hypertensive retinopathy and chorioretinopathy. Clin Optom (Auckl). 2020;12:67-73. doi:10.2147/OPTO.S183492
5.
RotsosTAndreanosKBlounasSBrouzasDLadasDSLadasID.Multimodal imaging of hypertensive chorioretinopathy by swept-source optical coherence tomography and optical coherence tomography angiography. Medicine. 2017;96:e8110.
6.
StryjewskiTPPapakostasTDEliotD.Multimodial imaging of Elschnig spots: a case of simultaneous hypertensive retinaopathy, choroidopathy, and neuropathy. Semin Ophthalmol. 2016;15:1-3.
7.
NguyenTTGinTNichollsKLowMGalanosJCrawfordA.Ophthalmological manifestations of Fabry disease: a survey of patients at the Royal Melbourne Fabry Disease Treatment Centre. Clin Exp Ophthalmol. 2005;33(2):164-168.
8.
AmaroDCarreñoESteeplesLROliveira-RamosFMarques-NevesCLealI.Tubulointerstitial nephritis and uveitis (TINU) syndrome: a review. Br J Ophthalmol. 2020;104(6):742-747.
9.
KayazawaFMiyakeK.Ocular fluorophotometry in patients with essential hypertension. Arch Ophthalmol. 1984;102(8):1169-1170
10.
DanaMRWernerMSVianaMA, et al. Spontaneous and traumatic vitreous hemorrhage. Ophthalmology. 1993;100(9):1377-1383.
11.
CiofaloAGulottaGIannellaG, et al. Giant cell arteritis (GCA): pathogenesis, clinical aspects and treatment approaches. Curr Rheumatol Rev. 2019;15(4):259-268. doi:10.2174/1573397115666190227194014
12.
NomaHFunatsuHMimuraTEguchiS.Vitreous inflammatory factors and serous retinal detachment in central retinal vein occlusion: a case control series. J Inflamm (Lond). 2011;8:38. doi:10.1186/1476-9255-8-38
