Malignant hypertension causing severe chorioretinopathy

Abstract

A 20-year-old male with uncontrolled hypertension secondary to cytoplasmic-staining antineutrophil cytoplasmic antibody (C-ANCA)–associated renal vasculitis presented with 3 weeks of gradual blurred vision bilaterally. His blood pressure (189/127 mm Hg at presentation) had reached 200/130 mm Hg in the preceding weeks. Visual acuity was 20/70 OD and 20/60 OS. Fundus examination revealed subtle bilateral optic disc edema, abundant acute Elschnig spots, flame-shaped hemorrhages, and inferior exudative retinal detachments (Fig.