Severe bilateral hypertensive retinopathy and optic neuropathy in a patient with pheochromocytoma.

Abstract

BACKGROUND:

We present a case of severe bilateral hypertensive retinopathy and optic neuropathy due to pheochromocytoma.

HISTORY AND SIGNS:

A 31-year-old woman presented with severe bilateral visual acuity loss associated with headaches and photophobia. Ophthalmoscopy showed bilateral optic disc edema, soft exudates, macular star, flame-shaped hemorrhages and arterial narrowing. The situation was more severe in the right eye. Fluorescein angiography confirmed the diagnosis of hypertensive retinopathy. Arterial blood pressure was 220/145 mmHg. A thorough systemic control revealed a right adrenal gland mass. Catecholamine secretion was normal. After ablation, the tumor proved to be a pheochromocytoma, and immunohistochemistry showed dopamine secretion.

THERAPY AND OUTCOME:

Postoperative evolution was uncomplicated. Antihypertensive treatment lasted only a few months. Visual acuity was restored and the retinal alterations disappeared 8 months after surgery.

CONCLUSIONS:

Severe hypertensive retinopathy with optic neuropathy may be a consequence of malignant hypertension due to a pheochromocytoma. It is reversible after ablation of the tumor. Early diagnosis is of vital importance and relies on hormonal investigation and immunohistochemistry.

• Authors: D Petkou, I K Petropoulos, A Kordelou, J M Katsimpris
• Journal: Klinische Monatsblatter fur Augenheilkunde (Klin Monbl Augenheilkd) Vol. 225 Issue 5 Pg. 500-3 (May 2008) ISSN: 0023-2165 [Print] Germany
• PMID: 18454411 (Publication Type: Case Reports, Journal Article)

Topics

• Adrenal Gland Neoplasms (complications, diagnosis)
• Adult
• Female
• Humans
• Hypertension, Portal (complications, diagnosis)
• Optic Nerve Diseases (diagnosis, etiology)
• Pheochromocytoma (complications, diagnosis)
• Retinal Diseases (complications, diagnosis)