First Author: R.Almeida PORTUGAL
Co Author(s): M. Ruão F.D. Rodrigues F. Rodrigues M. Amorim J. Chibante-Pedro 0 0 0 0 0 0 0 0 0
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The authors describe two cases of hypertensive retinopathy, present its clinical aspects and medical investigation findings.
Centro Hospitalar de Entre o Douro e Vouga
Retrospective case report
The first case is of a 46 years old male who presented at the ophthalmology emergency department complaining of right visual acuity loss and headache. He had history of essential hypertension and he stopped his medication 6 months before. The ophthalmological evaluation revealed a best corrected visual acuity (BCVA) of 20/60 OD and 20/20 OS. Slit lamp examination was unremarkable. Fundoscopy showed slight optic disc swelling, macular edema, generalized arteriolar narrowing, retinal hemorrhages, exudates and cotton wool spots. Physical examination revealed high blood pressure, 210/130 mmHg. The second case is of a 44 years old male who also presented at the ophthalmology emergency department complaining of left visual acuity loss lasting for 5 days, without any other symptom. He had history of essential hypertension, dyslipidemia and kidney stones. His ophthalmological evaluation revealed a BCVA of 20/20 OD and counting fingers OS. Fundoscopy showed a pale optic disc swelling, generalized arteriolar narrowing and cotton wool spots. Physical examination revealed a blood pressure of 193/123 mmHg. Both patients were referred to the Internal Medicine Department. Systemic workup revealed cardiopathy, cerebral microangiopathy and kidney failure in the first one and kidney failure in the second one.
Hypertension is a worldwide problem associated with cardiovascular risk and systemic target organ damage, but some patients remain unsupervised. Hypertensive retinopathy remains a recognized manifestation of target organ damage in hypertensive patients and in this cases was the key to diagnose a malignant hypertension. Early recognition of hypertensive retinopathy signs remains an important step in the risk stratification of hypertensive patients. Prevention, treatment and control of hypertension are essential attitudes to minimize organ damages.