Malignant hypertension – Optical coherence tomography grading and optical coherence tomography characteristics

Abstract

This photo essay describes the fundoscopic and optical coherence tomography (OCT) grading and characteristics of hypertensive retinopathy (HTR). A 34-year-old male presented with decreased vision of 20/40 N10 in both eyes following diagnosis of malignant hypertension. Fundus examination showed papilledema, intraretinal transudates, cotton wool spots, arteriovenous crossing changes, and superficial and deep hemorrhages with a partial macular star consistent with Grade 4 HTR. OCT macula revealed changes in the nerve fiber layer, outer nuclear layer, outer plexiform layer, and outer photoreceptor layer comprising inner segment/outer segment (OS) layer, external limiting membrane, and cone OS tips under the fovea with varied central subfoveal thickness. The fundoscopy grading of HTR was Keith–Wagener–Barker Grade 4 and that of OCT grading was Ahn Grade 3.

Keywords

• malignant hypertension
• optical coherence tomography characteristics
• optical coherence tomography grading