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. 1A, B). Fluorescein angiography showed delayed and patchy choroidal filling with widespread hyperfluorescent spots (Fig. 1C, D). This case demonstrates the appearance of acute fundus findings resulting from choroidal infarction and the presence of exudative retinal detachments, indicating blood–retinal barrier impairment. The patient was counselled on blood pressure control to prevent further vision loss.
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Published online: December 05, 2022
Accepted: November 9, 2022
Received: October 3, 2022
Publication stageIn Press Corrected Proof
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