Hemorrhagic Choroidal Detachment Research Articles

Acetazolamide –friend to foe

Bilateral acute angle closure attacks are rare and usually secondary to drugs or concurrent microspherophakia. Acetazolamide, a sulphonamide medication used in controlling intraocular pressure, is known to cause uveal effusion precipitating secondary acute angle closure attack. Here we report a well-documented case of concurrent bilateral angle closure with shallowing of the anterior chamber, supra-ciliary effusion, and serous and hemorrhagic choroidal detachment after administration of oral acetazolamide that resolved on withdrawing the insulting agent.

Coexistence of choroidal melanoma and rhegmatogenous retinal detachment: a case report and literature review

Introduction and importance: The simultaneous occurrence of rhegmatogenous retinal detachment (RRD) and choroidal melanoma is extremely rare, and diagnosis of choroidal melanoma in RRD patients is challenging. As a result, choroidal masses in RRD patients tend to be overlooked, resulting in delayed treatment. The authors report a rare case presenting with simultaneous choroidal melanoma and RRD, and the authors review the related literature. Case presentation: A 45-year-old Thai man who presented with inferior RRD and choroidal elevation in the left eye was examined using fundoscopy and ultrasonography. The presumptive diagnosis was simultaneous RRD and haemorrhagic choroidal detachment (CD). Vitrectomy and external drainage were attempted but were unsuccessful in draining fluid from the presumed haemorrhagic CD. Although the retina was reattached, the choroidal elevation remained unchanged. After being lost to follow-up, the patient returned later with severe proptosis in the left eye. MRI findings suggested a presumptive diagnosis including choroidal melanoma and choroidal metastasis, which choroidal melanoma was later confirmed through histopathological examination after exenteration. Clinical discussion: Important clinical clues were provided for distinguishing between choroidal melanoma and haemorrhagic CD in cases of coexisting RRD. Conclusions: In the differential diagnosis of RRD with suspicious choroidal elevation, the possibility of the presence of choroidal melanoma should be considered. In particular, in cases where haemorrhagic CD fails to drain during surgery, the possibility of underlying choroidal melanoma should be investigated.

Simultaneous macular hole with retinal and hemorrhagic choroidal detachments

Simultaneous macular hole with retinal and hemorrhagic choroidal detachments

Clinical features and outcomes of breakthrough vitreous hemorrhage secondary to polypoidal choroidal vasculopathy.

Polypoidal choroidal vasculopathy (PCV) with hemorrhagic complications is at higher risk for breakthrough vitreous hemorrhage (VH). This study aimed to evaluate the clinical features and outcomes of breakthrough VH secondary to PCV. Data of patients receiving pars plana vitrectomy for breakthrough VH secondary to PCV (VH group) were evaluated retrospectively and compared statistically to data of age and sex-matched PCV patients without breakthrough VH (control group). Among PCV patients, 36 eyes with breakthrough VH and 62 eyes without VH were included. Compared with baseline, best corrected visual acuity (BCVA) was worse in the VH group (P < 0.001), and improved postoperatively (P < 0.001). Percentages of pigmented epithelial detachment (PED), hemorrhagic PED, massive subretinal hemorrhage, hemorrhagic retinal detachment (RD), and hemorrhagic choroidal detachment (CD) (P = 0.007) were higher in the VH group (P < 0.001). Incidence of choroidal vascular hyperpermeability (P < 0.001), massive subretinal hemorrhage (P = 0.001), hemorrhagic retinal detachment (P = 0.001) and hemorrhagic type PCV (P = 0.001) was higher in patients with pachychoroid PCV, while fibrovascular type had lower incidence (P < 0.001). Better initial BCVA (P < 0.001), higher frequency of anti-VEGF treatment (P = 0.009), and previous photodynamic therapy (P = 0.017) showed better visual outcomes. Breakthrough VH risk is higher in PCV patients with massive subretinal hemorrhage, hemorrhagic PED and hemorrhagic RD. BCVA and hemorrhagic complications improve significantly postoperatively. Higher frequency of anti-VEGF treatment and previous photodynamic therapy are associated with better visual prognosis in PCV patients with breakthrough VH.

Management of Serous and Hemorrhagic Choroidal Detachments and Complications.

Management of Serous and Hemorrhagic Choroidal Detachments and Complications.

Hemorrhagic choroidal detachment as an initial manifestation of malignant hypertension in a young patient with nephropathy

Hemorrhagic choroidal detachment as an initial manifestation of malignant hypertension in a young patient with nephropathy

Intraoperative choroidal detachment during small-gauge vitrectomy: analysis of causes, anatomic, and visual outcomes

IntroductionTo investigate the incidence and causes of intraoperative choroidal detachment (CD) during small-gauge vitrectomy, as well as the anatomic and visual outcomes.MethodsWe retrospectively reviewed the medical records of 1026 consecutive patients who underwent small-gauge vitrectomy from June 2017 to December 2018 at Zhongshan Ophthalmic Centre, Guangzhou, China. Data on the presence, location, and extent of intraoperative CD and its relationship to the infusion cannula were collected. Patient demographic characteristics and postoperative anatomic and visual outcomes were also assessed.ResultsA total of six cases were found to have intraoperative CD, including two with serous CD, three with limited haemorrhagic CD, and one with CD caused by inadvertent perfusion of gas during air/fluid exchange. Retraction of the infusion cannula and acute ocular hypotony were found to be the main causes of intraoperative CD in five out of the six cases. The best-corrected visual acuity of all cases significantly improved after the surgery.ConclusionThe incidence of intraoperative CD during small-gauge vitrectomy is low; the predominant causes are retraction of the infusion cannula and acute ocular hypotony. Immediate awareness and timely closure of the incision may contribute to a better surgical prognosis.

Hypotony-associated Complications After Deep Sclerectomy: Incidence, Risk Factors, and Long-term Outcomes.

Chronic hypotony is not uncommon following deep sclerectomy (DS), but only a minor proportion of patients develop hypotony-associated complications. Numerical hypotony does not affect the visual outcomes. This study identifies factors associated with hypotony. To investigate the incidence and risk factors of hypotony and hypotony-associated complications after DS. Retrospective cohort study of 1765 eyes (1385 patients) undergoing DS with or without cataract extraction between 2001 and 2020 in 2 UK centers. Chronic hypotony was defined as intraocular pressure (IOP) ≤5 mm Hg in ≥2 consecutive visits lasting >90 days or as any IOP ≤5 mm Hg associated with hypotony-related complications or requiring surgical intervention. Clinical hypotony was defined as the presence of: serous or hemorrhagic choroidal detachment, hypotony maculopathy, flat anterior chamber requiring reformation, decompression retinopathy. The incidence of hypotony was calculated with Kaplan-Meier statistics, and Cox regression was used to identify risk factors. The median (interquartile range) age and follow-up were 76 (67 to 82) years and 45.4 (20.9 to 79.8) months, respectively. The incidence (95% confidence interval) of chronic and clinical hypotony at 5 years was 13.4% (11.5%-15.3%) and 5.6% (4.3%-6.9%), respectively. Sixteen eyes (15.7%) with hypotony-associated complications had IOP >5 mm Hg. Male sex (hazard ratio [HR]: 1.89, P=0.018), non-Caucasian ethnicity (HR: 2.49, P=0.046), intraoperative bevacizumab (HR: 3.96, P=0.01), pigmentary glaucoma (HR: 3.59, P=0.048), previous vitreoretinal surgery (HR: 5.70, P=0.009), intraoperative microperforation (HR: 4.17, P<0.001) and macroperforation (HR: 20.76, P<0.001), and avascular bleb (HR: 1.80, P=0.036) were associated with clinical hypotony. Chronic hypotony is not uncommon following DS, but clinical hypotony is infrequent. Hypotony associated-complications can occur in eyes without statistical hypotony.

A Stepwise Approach to the Surgical Management of Hemorrhagic Choroidal Detachments.

This work describes a stepwise surgical approach to draining choroidal detachments and 2 cases for which this approach was used. The first step involves insertion of an anterior chamber maintainer and a nonvalved 23- or 25-gauge trocar cannula at the highest peak of hemorrhagic choroidal detachment (as determined using B-scan ultrasonography), 6 to 8 mm from and angled 20° to 30° toward the limbus. The second step involves removal of the trocar to expose the sclerotomy. Alternatively, the second step can be insertion of a second trocar. The third step involves the creation of a small focal peritomy around the preexisting sclerotomy and enlargement of the preexisting sclerotomy into a radial sclerotomy. Progression between steps only occurs if prior steps did not provide adequate drainage. Two cases of appositional hemorrhagic choroidal detachments in hypotonic eyes were successfully resolved by this stepwise approach. In case 1, a choroidal detachment developed after a corneal ulcer perforation. The hemorrhagic choroidal detachment in case 1 was resolved with steps 1 and 2, and an unnecessary scleral cutdown was avoided. In case 2, a choroidal detachment developed after a trabeculectomy. The detachment in case 2 required progression to step 3, extension of the trocar insertion site into a radial sclerotomy. This stepwise approach should be considered to reduce excessive manipulation of the globe and conjunctiva in hemorrhagic and serous choroidal detachments that warrant surgical intervention.

An Alternative Approach for External Drainage of Suprachoroidal Hemorrhage: Active Aspiration with Butterfly Needle

ABSTRACT Purpose: To describe a novel surgical technique for external drainage of choroidal detachment/suprachoroidal hemorrhage with a butterfly needle. Materials and Methods: This is a retrospective case series on six eyes with serous and/or hemorrhagic choroidal detachments due to previous intraocular surgery or perforating ocular trauma that underwent active external suprachoroidal fluid drainage procedure with butterfly needle. The primary outcome measures were perioperative controlled fluid discharge and presence of choroidal detachment at 1 week, 1 month, and 6 months postoperatively. Secondary outcome measures were postoperative visual acuity and intraocular pressure. Results: During drainage, controlled hemorrhage discharge was observed. Drainage resolved hemorrhagic choroidal detachments at 1 week postoperatively. Intraocular pressure significantly increased, and visual acuity improved in all eyes. No complications were noted. Conclusion: Management of hemorrhagic choroidal detachment is challenging, and external drainage can be complicated. Active aspiration of hemorrhagic material with a butterfly needle may help early resolution.

Common and rare complications following filtering surgery for children with congenital glaucoma; a5 years study.

To determine the incidence of postoperative complications following combined trabeculotomy trabeculectomy with mitomycin C (CTTM) for congenital glaucoma (CG), in addition to documentation of some unusual complications and possible ways to manage these complications safely with minimal morbidity. A retrospective observational study was performed on 190 eyes with CG had a CTTM procedure.Included eyes were operated upon between February 2015 and February 2020 in Sohag University Hospitals. Medical records were reviewed and postoperative complications were reported. Incidence of postoperative complications and their management were the main outcome measures. Early complications developed the form of shallow anterior chamber (AC) (16.3%), hyphema (10.5%), serous choroidal detachment (2%), hemorrhagic choroidal detachment (2%). Unusual and rare complications occurred in the form of iatrogenic Cushing syndrome, unilateral toxic keratopathy developed, vitreous hemorrhage (VH), intercalary staphyloma and decompression retinopathyLate complications included: high postoperative intraocular pressure (IOP) (16.5%), thin cystic blebs (13.1%), hypotony disc edema (2%), cataract (3.2%), one eye developed blebitis and one eye developed endophthalmitis. Surgical management of CG is full of complications in early and late postoperative periods such as shallow AC, hyphema and thin cystic blebs. Some unusual and rare complications developed such as iatrogenic Cushing syndrome, unilateral toxic keratopathy, vitreous hemorrhage, intercalary staphyloma and decompression retinopathy. If identified early; all these complications could be managed properly leading to a successful and favorable outcome.

Rare traumatic expulsion of the iris presenting as aniridia

A 55 year old male presented with pain and defective vision in left eye following blunt trauma with sugarcane stick. Anterior segment examination revealed periorbital edema, circumcorneal congestion, ruptured sclerocorneal tunnel with 360 iridodilaysis and iris extrusion through the scleral tunnel, corneal edema, blood staining of endothelium, anterior chamber was flat with eight ball hyphema and vitreous prolapse. A corneoscleral repair was performed with iris abscission, Intraocular lens explantation, anterior vitrectomy and anterior chamber reformation. Postoperative day 1 patient had well opposed sutured scleral tear, corneal edema with descemet membrane folds, anterior chamber hyphema, fibrinous membrane with blood clot over iris and aphakia. B-scan revealed 360 degree hemorrhagic choroidal detachments, retinal detachment with vitreous hemorrhage.

Incidence and Outcomes of Suprachoroidal Hemorrhage Following Aurolab Aqueous Drainage Implant in Adult and Pediatric Glaucoma.

Postoperative suprachoroidal hemorrhage (PSCH) is an infrequent but devastating complication after nonvalved aqueous drainage implant surgery and demonstrated a bimodal distribution. The final outcomes of either conservative management or surgical drainage of the hemorrhage remained poor. The aim was to report the incidence and outcomes of eyes developing PSCH after undergoing Aurolab aqueous drainage implant (AADI) surgery for adult and pediatric refractory glaucomas. In this retrospective series, case files of all patients who underwent AADI between May 2012 and December 2019 were retrieved from an electronic database. A PSCH was defined as the presence of hemorrhagic choroidal detachment, confirmed by ultrasound B scan, occurring in a closed system in the postoperative period. Of the 986 eyes that underwent AADI during the study period, 7 (0.7%), developed PSCH (95% confidence interval=0.3-1.6%). There were no differences in the preoperative parameters between those with and without PSCH. Of these, 4 were seen in pediatric eyes (4/288, 1.4%) and 3 in adult eyes (3/698, 0.4%) (P<0.01). Four eyes (57%) had PSCH in the immediate postoperative period (ie, between 24 and 48 h of AADI surgery), while the remaining 3 had onset ranging from 6 to 7 weeks after surgery. Anatomic risk factors were present in all eyes including hypotony (n=4), myopia (n=3), microcornea (n=2), microphthalmos (n=1), postvitrectomy (n=1), and staphyloma (n=1). Visual acuity improved in only 1 (14%) eye while 3 (43%) eyes developed phthisis bulbi, all in the pediatric age group. PSCH is a rare complication following AADI and is seen in <1% eyes. The incidence is higher in the pediatric age group. Visual and anatomic outcomes are dismal following PSCH with globe salvage possible in only about half these eyes.

Case Report: Suprachoroidal Hemorrhage after Chiropractic Manipulation of the Neck

The case report highlights the possible complications of undergoing neck manipulation within a critical time period after intravitreal injection. This study aimed to describe a case of traumatic hemorrhagic choroidal detachment after cervical manipulation during a chiropractic treatment session. A 43-year-old male patient with a history of complex rhegmatogenous retinal detachment repair and recurrent cystoid macular edema presented with decreased vision and sudden pain in the right eye after chiropractic manipulation of the neck, status post-intravitreal injection of triamcinolone, which was performed earlier that day. Vision in the right eye was hand motion and 20/20 in the left eye. IOPs were 8 and 11 mmHg, respectively. Slit lamp examination of the right eye revealed blood-tinged steroid residues in the anterior chamber. There was no view to the posterior pole. Ultrasonography showed a lobulated mass with heterogeneous echogenicity consistent with a large hemorrhagic choroidal detachment. No central kissing was observed. Left eye examination was unremarkable. With the increasing use of complementary and alternative medicine, a better understanding of potential complications to raise awareness is becoming essential.

Capabilities of cytostatic agents usage in ophthalmology

Antineoplastic drugs are increasingly used in the treatment of diseases of the vision organ. However, practicing ophthalmologists often deal with lack of information about the choice of drugs with anticancer effect, their mechanism of action, dosage, route of administration, potential side effects including their prevention. Mechanism of action is presented for the most commonly used immunosuppressants in ophthalmology (such as metabolic antagonists, alkylation agents, antineoplastic antibiotics, monoclonal antibodies). Efficiency and routes of administration are described for cytostatics used for the treatment of intraocular tumors (retinoblastoma), for prevention and treatment of proliferative syndrome in ophthalmosurgery complicating the surgery for glaucoma, pterigium and refractive corneal procedures, and presenting the pathogenetic basis of proliferative vitreoretinopathy and posterior lens capsule opacity. Possible local side effects of immunosupressors in ocular surgery are presented (epithelial and suture defects, hemorrhagic choroidal detachment, cataract progression, endophthalmitis, malignant glaucoma, toxic effect on the ciliary body, keratopathy, hypertensive maculopathy). Also, the issue of the use of cytostatics and immunodepressants for acute and chronic inflammatory eye diseases is discussed (for example, for uveitis, filamentary ke­ratitis, allergic blepharoconjunctivitis, allergic conjunctivitis and spring ophthalmia, adenoviral keratoconjunctivitis, rosacea keratitis, ocular pemphigoid, recurrent chalazion, scleritis, episcleritis, painful bullous keratopathy, state after keratoplasty and refractive surgery of ocular fibrous capsule). Special attention was paid to the eye neovascularization and common use of intravitreal injections of monoclonal antibodies (ranibizumab, aflibercept) for premature infants’ retinopathy, choroidal neovascularization of various origin (in trauma, myopia, histoplasmosis), neovascular form of age-related macular dystrophy, secondary neovascular glaucoma, proliferative diabetic retinopathy and diabetic macular edema. Need for search of new more effective and safe medicines with antineoplastic and immunodepressive action is emphasized for ophthalmology, eye surgery and medicine in general.

First Simultaneous Explantation and Re-Implantation of an Argus II Retinal Prosthesis System

A 59-year-old blind woman with retinitis pigmentosa had undergone implantation of an Argus II system without complications and took advantage of the system for 7 months. Due to a technical error of the system, the glasses of the prosthesis developed increased heat generation, making the use of the system unbearable. Because of the initial satisfaction and high motivation of the patient, it was decided to strive for an implant exchange. In a 4-hour surgery session, the implant was removed and a new system was implanted. Hereby, several critical surgery steps could be identified that are important to consider for future surgeries. Besides a strong fibrotic scarring of conjunctiva and tenon aggravating the extraction of the extraocular components, the preparation of the sclerotomy proved to be difficult for achieving water tightness. Furthermore, the extraction of the retinal tack and the repositioning of the new array were challenging steps. During the postoperative course, a severe hemorrhagic choroidal detachment occurred but resolved without surgical intervention. The implant was well-placed and showed good function. The exchange of an Argus II is feasible, however, with the challenge of hypotony and hemorrhage as well as possible fibrosis complicating the repositioning of the chip. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:462-465.].

Vitreoretinal Complications and Outcomes in 92 Eyes Undergoing Surgery for Modified Osteo-Odonto-Keratoprosthesis: A 10-Year Review

To analyze vitreoretinal (VR) complications and treatment outcomes in eyes undergoing modified osteo-odonto-keratoprosthesis (OOKP) surgery. Retrospective case series. All patients who underwent modified OOKP (mOOKP) surgery at a tertiary eye-care center from March 2003 to February 2013 were included. Medical records were reviewed for relevant medical history, best-corrected visual acuity (BCVA), slit-lamp examination, ultrasound scan, oral examination findings, and VR complications. The BCVA at the last visit. Optimal anatomic outcome was attached retina with a normal intraocular pressure at the last visit. A total of 92 eyes of 90 patients were included. Indications for OOKP included Stevens-Johnson syndrome (n= 53), chemical injury (n= 36), and ocular cicatricial pemphigoid (n= 3). A total of 41 eyes of 39 patients developed VR complications, including vitritis (n= 21), retinal detachment (RD) (n= 12; primary RD= 5), retroprosthetic membrane (RPM) (n= 10; primary RPM= 2), endophthalmitis (n= 8), vitreous hemorrhage (VH) (n= 5; primary VH= 1), serous choroidal detachment (n= 5), hemorrhagic choroidal detachment (n= 2), and leak-related hypotony (n= 1). Mean interval from mOOKP surgery to occurrence of VR complication(s) was 43.8 months (median, 41.9 months; range, 0.2-95.5 months). After treatment of VR complication, visual improvement was seen in 17 eyes (42%) (mean improvement= 1.2 logarithm of the minimum angle of resolution [logMAR]; median, 0.8 logMAR; range, 0.1-2.5 logMAR), visual decline in 7 eyes (14%) (mean decline in BCVA= 0.6 logMAR; median, 0.4 logMAR; range, 0.3-1.8 logMAR), and no change in BCVA in 17 eyes (42%). However, BCVA ≥6/60 was retained in 19 eyes and ≥6/18 was retained in 9 eyes after final VR treatment. Vitreoretinal complications constitute a significant cause of visual morbidity in eyes undergoing mOOKP surgery and pose a challenging situation to manage. However, appropriate and timely intervention can achieve encouraging results.

Venous Air Embolism During Pars Plana Vitrectomy: A Case Report and Review of the Literature

Purpose: Presumed venous air embolism (PVAE) is a rare and potentially fatal complication of pars plana vitrectomy that is poorly described and understood but requires improved awareness among ophthalmologists and vitreoretinal surgeons. Methods: A case report is presented along with a systematic review of published reports of PVAE during ocular surgery. Results: An otherwise healthy adult male undergoing retinal detachment repair under local anesthesia with monitored anesthesia care died from a PVAE. Literature search yielded 2 experimental models, 6 individual case reports, and several editorials. Review of existing reports reveals that PVAE can affect patients of any age or gender with no medical predilection and occurs in cases of trauma, endoresection, or retinal detachment repair. It is typically associated with a drop in end-tidal carbon dioxide during fluid–air exchange and can present similar to a hemorrhagic choroidal detachment. Analysis suggests that venous air embolism can be prevented by ensuring full engagement of the infusion cannula into the vitreous cavity prior to fluid–air exchange. Conclusion: Presumed venous air embolism is a potentially fatal complication of ocular surgery and in some cases may be recognized by ophthalmologists as a choroidal detachment during fluid–air exchange in pars plana vitrectomy. It is imperative to immediately stop the air infusion line if venous air embolism is suspected.

MACULAR BUCKLING USING A THREE-ARMED SILICONE CAPSULE FOR FOVEOSCHISIS ASSOCIATED WITH HIGH MYOPIA.

To investigate the safety and efficacy of a novel macular buckling technique on foveoschisis in highly myopic eyes. Highly myopic eyes with foveoschisis, posterior staphyloma, and axial length greater than 26.5 mm, but without a full-thickness macular hole, were included. Macular buckling was performed in the included eyes using a three-armed adjustable silicon capsule. Eight eyes from eight patients (five women) were enrolled in this study. The mean follow-up period was 11.6 (range 9-14) months. After surgery, the best-corrected visual acuity was improved in 7/8 (87.5%) eyes, optical coherence tomography imaging showed gradual anatomic improvement of macula over time. The final best-corrected visual acuity gained 21.5 early treatment diabetes retinopathy study letters from baseline on average (P = 0.014). Postoperatively, the most common complications were transiently elevated intraocular pressure (62.5%) and asymptomatic abduction limitation (100%), and the most serious complication was hemorrhagic choroidal detachment (25%). Macular buckling with a three-armed adjustable silicone capsule resulted in anatomic and visual improvement in eyes with myopic foveoschisis.

Retinal vascular changes in hypertensive patients in Ibadan, Sub-Saharan Africa.

BackgroundEarlier studies in Nigeria reported the rarity of retinal vascular changes in hypertensives. The aim of this study was to describe the various retinal vascular changes in the hypertensive patients of Nigeria.Patients and methodsNine hundred and three hypertensive patients were studied. This study was approved by the ethical and research committee of the University of Ibadan and University College Hospital, Ibadan, Nigeria. Blood pressure and anthropometric measurements were measured. Cardiac echocardiography was performed on 156 patients. All patients had dilated fundoscopy and fundus photography using the Kowa portable fundus camera and an Apple iPhone with 20 D lens. Statistical analysis was done with Statistical Packages for the Social Sciences (Version 21).ResultsThe mean age of patients was 57 years with a male:female ratio of 1. No retinopathy was found in 556 (61.5%) patients. In all, 175 (19.4%) patients had features of hypertensive retinopathy. Retinal vascular occlusion was a significant finding in 121 patients (13.4%), of which branch retinal vein occlusion, 43 (4.7%), and central retinal vein occlusion, 30 (3.3%), were the most prominent ones in cases. Hemicentral retinal vein occlusion, 26 (2.9%), and central retinal artery occlusion, 17 (1.9%), were significant presentations. Other findings included nonarteritic anterior ischemic optic neuropathy in five (0.6%) patients, hypertensive choroidopathy in seven (0.8%) patients, and hemorrhagic choroidal detachment in five (0.6%) patients. Left ventricular (LV) geometry was abnormal in 85 (55.5%) patients. Concentric remodeling, eccentric hypertrophy, and concentric hypertrophy were observed in 43 (27.6%), 26 (17.2%), and 15 (9.7%) patients, respectively. LV hypertrophy was found in 42 (27%) patients, while 60 (39%) patients had increased relative wall thickness. In this study, bivariate analysis showed a correlation between LV relative wall thickness and severity of retinopathy in both eyes (Spearman’s coefficient 0.6; P=0.0004).ConclusionHypertensive retinal vascular changes are not rare in Ibadan.