Malignant hypertensive retinopathy-clinical and fundus manifestations in patients with new onset or acute exacerbation of chronic hypertension.

Background: We attempted to review the clinical and fundus findings in patients with malignant hypertension (MHT).

Methods: Charts and fundus photographs of patients with malignant hypertensive retinopathy from 1995 to 2000 were retrospectively reviewed. Data of patients were included when their color fundus photographs revealed findings suggestive of malignant hypertension (MHT). There had to have been at least 1 high blood pressure reading recorded in the chart during the period when the symptoms occurred. Data were excluded from patients with diseases such as diabetes mellitus, blood dyscrasia, and autoimmune and infectious diseases which can mimic the fundus findings of MHT.

Results: Fourteen patients were included in our study. Patients were divided into 2 groups according to whether or not they had a history of hypertension. Group 1 included 6 patients with no hypertension history, while group 2 included 8 patients with a known hypertension history. In group 1, MHT was diagnosed by an ophthalmologist in 4 patients, and the other 2 patients were referred from the Gynecology and Nephrology Departments. Between the 2 groups, there were no significant differences in age, or systolic and diastolic blood pressures. There were more complications such as renal failure and stroke in group 2 patients.

Conclusion: Funduscopy has decisive significance in the diagnosis and monitoring of MHT. In order to accurately diagnose and achieve early control of this critical condition, a detailed fundus examination and blood pressure monitoring are mandatory.