Abstract
Purpose: :
To evaluate fundus lesions using indocyanine green angiography (IA) in patients with malignant hypertension.
Methods: :
Two hypertensive choroidopathy patients were prospectively followed with IA, fluorescein angiography (FA) and optical coherence tomography (OCT) examinations.
Results: :
Case 1, a 33–year old man, had a ten day history of blurred vision in both eyes. Visual acuity (VA) was 0.2 in the right eye, 0.02 in the left. His blood pressure (BP) was 271/172 mmHg and laboratory data were consistent with severe renal dysfunction. Case 2, a 31–year old man, had a seven day history of blurred vision in both eyes. VA was 1.2 in the right eye, 1.0 in the left. BP was 271/172 mmHg. Marked optic edema, retinal hemorrhage, cotton wool patches and Elschnig spots were seen in both cases. FA showed poor perfusion of the choroid in the early phase and fluorescein dye leakage from the optic disc. OCT showed serous retinal detachment in both cases. On IA, Elschnig spots corresponded to the patchy choroidal filling defects. IA showed a larger choroidal filling defect than FA. In case 1, IA showed dye leakage from large choroidal vessels. These OCT and IA findings diminished with prompt systemic treatment for malignant hypertension.
Conclusions: :
There is a possibility of reversing the damaging effects of choriocapillaris occlusion and choroidal vessel damage with early treatment of malignant hypertension. IA is useful for demonstrating disturbance of the choroidal circulation in hypertensive choroidopathy.
Keywords: imaging/image analysis: clinical • choroid • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)