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Hypertensive retinopathy in a neonate
Prakhar Goyal1, Komal Agarwal2
1Srimati Kannuri Santhamma Center for Vitreo-retinal Diseases, LV Prasad Eye Institute, Hyderabad, India.
BMJ Case Reports
|October 31, 2020
Summary
Hypertensive retinopathy in a neonate is rare, presenting with retinal hemorrhages and exudates. Long-term visual development can be affected, even after hypertension control.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Hypertension
Background:
- Systemic hypertensive emergency in neonates is a critical condition requiring prompt management.
- Retinal screening is crucial for early detection of ocular complications in neonates with hypertension.
- Hypertensive retinopathy, characterized by retinal changes, can impact visual development.
Observation:
- A 23-day-old female neonate presented with hypertensive retinopathy, including bilateral intraretinal hemorrhages and hard exudates.
- Fundus examination revealed macular involvement and venous looping, indicative of severe hypertension.
- Widefield fundus photography documented the initial presentation and progression of retinopathy.
Findings:
- Conservative management of systemic hypertension led to the resolution of hemorrhages and exudates.
- Persistent retinal pigment epithelium changes, including a 'beaten bronze' appearance, were observed post-hypertension control.
- The case highlights the rarity and potential long-term visual consequences of neonatal hypertensive retinopathy.
Implications:
- Early diagnosis and management of neonatal hypertension are vital to prevent irreversible ocular damage.
- Neonatal hypertensive retinopathy necessitates long-term monitoring for visual development.
- This case underscores the importance of comprehensive ophthalmic evaluation in neonates with hypertensive emergencies.
