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Fundus fluorescein angiography of patients with severe hypertensive nephropathy

  • Clinical Investigation
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Abstract

• Purpose: To analyze the fluorescein angiograms of patients with hypertensive renal failure. • Methods: Fluorescein angiograms were obtained of 34 patients with hypertensive renal failure. The glomerular filtration was less than 20 ml/min in each patient. • Results: Capillary nonperfusion and a coarse retinal capillary bed are the hallmark of the hypertensive retinopathy. Tortuons retinal arterioles or tortuous retinal arteriovenous anastomoses are observed. It is suggested that capillary collaterals shunt arterioler obstructions or short-cut nonperfused capillary beds; these remodel into tortuous arterioles or arteriovenous anastomoses with regular caliber. Elschnig spots and delayed choroidal filling are signs of hypertensive choroidopathy. Depigmentation spots of the retinal pigment epithelium without a central pigment clump are considered atypical Elschnig spots. • Conclusions: Retinal pigment epithelial changes are permanent scars of hypertensive choroidopathy, while coarse retinal capillary bed and tortuous retinal arterioles or arteriovenous anastomoses are the result of hypertensive retinopathy in these patients with hypertensive renal failure.

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References

  1. Ashton N (1972) The eye in malignant hypertension. Trans Am Acad Ophthalmol Otolaryngol 76:17–40

    CAS  PubMed  Google Scholar 

  2. Dollery CT, Henkind P, Paterson JW, Ramalho PS, Hill DW (1966) Ophthalmoscopic and circulatory changes in focal retinal ischaemia. Br J Ophthalmol 50:285–324

    CAS  PubMed  Google Scholar 

  3. Falkner B (1987) Is theie black hypertension? (editorial) Hypertension 10:551–554

    CAS  PubMed  Google Scholar 

  4. Gass JDM (1968) A fluorescein angiographie study of macular dysfunction secondary to retinal vascular disease. III. Hypertensive retinopathy. Arch Ophthalmol 80:569–582

    CAS  PubMed  Google Scholar 

  5. Hayreh SS (1989) Hypertensive retinopathy. Ophthalmologica 198:173–177

    CAS  PubMed  Google Scholar 

  6. Hayreh SS (1989) Classification of hypertensive fundus changes and their order of appearance. Ophthalmologica 198:247–260

    CAS  PubMed  Google Scholar 

  7. Hayreh SS (1996) Duke-Eider lecture. Systemic arterial blood pressure and the eye. Eye 10:5–28

    PubMed  Google Scholar 

  8. Hayreh SS, Servais GE, Virdi PS, Marcus ML, Rojas P, Woolson RF (1986) Fundus lesions in malignant hypertension. III. Arterial blood pressure, biochemical, and fundus changes. Ophthalmology 93:45–59

    CAS  PubMed  Google Scholar 

  9. Hayreh SS, Servais GE, Virdi PS (1986) Fundus lesions in malignant hypertension. IV. Focal intraretinal periarteriolar transudates. Opthalmology 93:60–73

    CAS  Google Scholar 

  10. Hayreh SS, Servais GE, Virdi PS (1986) Fundus lesions in malignant hypertension. VI. Hypertensive choroidopathy. Ophthalmology 93:1383–1400

    CAS  PubMed  Google Scholar 

  11. Hayreh SS, Servais GE, Virdi PS (1989) Retinal arteriolar changes in malignant arterial hypertension. Ophthalmologica 198:178–196

    CAS  PubMed  Google Scholar 

  12. Hayreh SS, Servais GE, Virdi PS (1989) Macular lesions in malignant arterial hypertension. Ophthalmologica 198:230–246

    CAS  PubMed  Google Scholar 

  13. Henkind P (1966) Ballotini occlusion of retinal arteries: collateral vessels. Br J Ophthalmol 50:482–495

    CAS  PubMed  Google Scholar 

  14. Henkind P, Dollery CT (1966) Pathophysiology of the retinal vascular bed following acute embolization. Invest Ophthalmol 5:204–207

    Google Scholar 

  15. Hilton AF, Harrison JD, Lamb AM, Petrie JJB, Hardie I (1982) Ocular complications in haemodialysis and renal transplant patients. Austr J Ophthalmol 10:247–253

    CAS  Google Scholar 

  16. Kaplan NM (1994) Ethnie aspects of hypertension. Lancet 344:450–452

    CAS  PubMed  Google Scholar 

  17. Keith NM, Wagener HP, Barker NW (1939) Some different types of essential hypertension: their course and prognosis. Am J Med Sci 197:332–343

    Google Scholar 

  18. Kishi S, Tso MOM, Hayreh SS (1985) Fundus lesions in malignant hypertension. I. A pathologie study of experimental hypertensive choroidopathy. Arch Ophthalmol 103:1189–1197

    CAS  PubMed  Google Scholar 

  19. Liebreich R (1859) Ophthalmoscopischer Befund bei Morbus Brightii. Graefes Arch Ophthalmol 5:265–268

    Google Scholar 

  20. Polak BC (1980) Ophthalmological complications of haemodialysis and kidney transplantation. Doc Ophthalmol 49:1–96

    Article  Google Scholar 

  21. Scheie HG (1953) Evaluation of ophthalmoscopic changes of hypertension and arteriolar sclerosis. Arch Ophthalmol 49:117–138

    CAS  Google Scholar 

  22. Shakib M, Ashton N (1966) Ultrastructural changes in focal retinal ischaemia. Br J Ophthalmol 50:325–384

    CAS  PubMed  Google Scholar 

  23. Stoumbos VD, Klein ML, Goodman S (1992) Purtscher's-like retinopathy in chronic renal failure. Ophthalmology 99:1833–1839

    CAS  PubMed  Google Scholar 

  24. Tso MOM, Jampol LM (1982) Pathophysiology of hypertensive retinopathy. Ophthalmology 89:1132–1145

    CAS  PubMed  Google Scholar 

  25. Winterkorn MS, Ptachewich Y (1995) Calcific retinal emboli and collateral shunting in a woman with rheumatic heart disease. Arch Ophthalmol 113:1464–1465

    CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Ophthalmology, University Hospital, De Pintelaan 185, B-9000, Gent, Belgium

    Bart A. Lafaut & Andries A. Stulting

  2. Department of Internal Medicine, Pelonomi Hospital, Bloemfontein, Republic of South Africa

    An S. P. De Vriese

Authors
  1. Bart A. Lafaut
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  2. An S. P. De Vriese
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  3. Andries A. Stulting
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Lafaut, B.A., De Vriese, A.S.P. & Stulting, A.A. Fundus fluorescein angiography of patients with severe hypertensive nephropathy. Graefe's Arch Clin Exp Ophthalmol 235, 749–754 (1997). https://doi.org/10.1007/BF02332858

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  • DOI: https://doi.org/10.1007/BF02332858

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