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Updated: Jul 9, 2025
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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
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Atypical presentation of malignant hypertension
Subashree Palani1, Deborah Rinita2, Amjad Salman3
1Ophthalmology, Karpaga Vinayaga Institute of Medical Science and Research Center, Maduranthagam, Tamil Nadu, India.
BMJ Case Reports
|December 7, 2023
Summary
Sudden vision loss in a hypertensive patient was linked to severe hypertension. Prompt blood pressure management led to vision recovery and resolution of hypertensive retinopathy signs.
Area of Science:
- Ophthalmology
- Cardiology
- Nephrology
Background:
- Hypertensive retinopathy is a complication of high blood pressure affecting the eyes.
- Severe hypertension can lead to rapid vision impairment and optic nerve damage.
Observation:
- A woman in her 30s experienced sudden vision loss in one eye.
- Fundus examination revealed optic disc edema, arteriolar attenuation, and macular serous detachment.
- Her blood pressure was critically high at 230/140 mm Hg.
Findings:
- The patient's condition was diagnosed as hypertensive retinopathy with a highly asymmetrical presentation.
- Following blood pressure reduction to 140/100 mm Hg, her visual acuity improved to 20/20.
- Fundus examination showed resolving optic disc edema with macular star formation and soft exudates in the other eye.
Implications:
- This case highlights the critical link between severe hypertension and acute vision loss.
- Prompt diagnosis and management of hypertension are crucial for preventing permanent visual impairment.
- Asymmetrical hypertensive retinopathy necessitates thorough systemic evaluation for uncontrolled hypertension.
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