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Elschnig's spots as a sign of severe hypertension
1Universitäts-Augenklinik, Freiburg, BRD.
Insights
Elschnig's spots, a sign of severe hypertension, showed significant retinal and choroidal changes. Despite extensive visual field alterations, functional vision remained largely intact, indicating potential for visual preservation.
Area of Science:
- Ophthalmology
- Cardiology
- Medical Imaging
Background:
- Severe hypertension can lead to characteristic ocular changes affecting both the choroid and retina.
- Understanding these changes is crucial for diagnosing and managing hypertensive retinopathy.
Observation:
- Elschnig's spots were identified in three patients with severe hypertension.
- Retinal examination revealed extensive choroidal depigmentation and hyperpigmentation, with Siegrist's bead string pigmentation noted peripherally in one patient.
- Choroidal vascular changes were prominent in acute hypertension, while retinal vascular changes suggested a more gradual onset.
Findings:
- Massive chorioretinal alterations were observed, yet functional vision remained only slightly affected.
- Retinal hypertensive changes were more dominant than choroidal vascular lesions in one patient.
- Elschnig's spots were predominantly unilateral in one case.
Implications:
- The findings highlight the varied presentation of hypertensive retinopathy and Elschnig's spots.
- Despite severe funduscopic findings, visual function may be preserved, suggesting the retina's resilience or adaptation.
- Differentiating between acute and chronic hypertension based on vascular changes is important for patient management.
Abstract:
Elschnig's spots were observed in 3 patients with severe hypertension. Extensive choroidal depigmentation as well as hyperpigmentation surrounded by depigmentation were scattered over the whole retina. At the periphery, Siegrist's bead string pigmentation was present (first patient). Despite the massive chorioretinal changes, only slight functional changes were evident. The retinal hypertensive changes predominated over choroidal vascular lesions (second patient). Elschnig's spots were present almost only unilaterally (third patient). Choroidal vascular changes predominated in the presence of acute hypertension (first and third patient), whereas retinal vascular changes were the result of a more gradual onset of hypertension (second patient).