Hypertensive choroidopathy

Abstract

Untreated systemic hypertension is associated with retinopathy, optic neuropathy, and choroidopathy. Hypertensive choroidopathy is less common than retinal hemorrhages and infarcts seen with accelerated hypertension. The manifestations of choroidopathy include serous retinal detachment, Elschnig spots, and Siegrist streaks. Elschnig spots are yellow demarcated lesions in the perimacular region that leak fluorescein after occlusion of the choriocapillaris. When the Elschnig spot heals, a pigment spot is left surrounded by a depigmented pale halo. Siegrist streaks are linear hyperpigment‐ed streaks over choroidal arteries. Hypertensive choroidopathy has been reported in toxemia of pregnancy, renal disease, pheochromocytoma, and malignant hypertension.

Figure 1

Elschnig spots (arrow) are the changes in the retinal pigment epithelium from nonperfused areas of the choriocapillaris. Photographed by Michael S. Stanley, ophthalmic photographer.

Figure 2

Siegrist streaks (arrows) are linear hyper‐pigmented streaks over choroidal arteries, and they denote ischemia of the choroidal lobules. These streaks observed in the temporal midperipheral retina are more hypopigmented as they are acute and will become pigmented. Photographed by Michael S. Stanley, ophthalmic photographer.