Abstract
A 54-year-old man was referred to the ophthalmology unit for blurring of vision in both eyes. On ophthalmic examination, his best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.7 in the left eye. Fundoscopy revealed disc swelling, cotton-wool spots, superficial retinal hemorrhages, and macular edema with hard exudates in both eyes. Optical coherence tomography (OCT) showed marked serous retinal detachment, involving the fovea, and cystic change of the inner retinal layer in both eyes. We diagnosed the condition as hypertensive retinopathy with marked serous retinal detachment caused by hypertensive choroidopathy. His blood pressure was 189/116 mmHg. There was no secondary cause of hypertension. Two months after resuming his regular medications, his BCVA improved to 0.6 in the right eye and 1.0 in the left eye, with regression of fundus changes, including serous retinal detachment. In malignant hypertension, both retinopathy and choroidopathy can occur, which can be detected on OCT.
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