Swept‐source optical coherence tomography angiography findings in hypertensive chorioretinopathy

Purpose To study malignant hypertension ocular findings with swept source optical coherence tomography (SS‐OCT) and optical coherence tomography angiography (OCT‐A). Methods In this retrospective study, we included patients with malignant hypertension associated to hypertensive chorioretinopathy. Clinical characteristics with multimodal imaging including SS‐OCT and OCT‐A were evaluated at baseline and during follow‐up. Results Seventeen eyes of nine patients were included. Fundus examination revealed signs of hypertensive chorioretinopathy in all cases. At baseline, SS‐OCT showed serous retinal detachment in 7 eyes, macular edema in 15 eyes and hard exudates in 13 eyes. Central macular thickness was 403.33 ± 257.92 µm at baseline and 261.08 ± 62.43 µm after 3 months of mean follow‐up (p = 0.05). Central choroidal thickness decreased from 352.06 ± 87.62 µm at baseline to 319.58 ± 80.66 µm after follow‐up (p > 0.05). On OCT‐A, all patients showed nonperfusion capillary areas at the level of the superficial and deep capillary plexuses. The choriocapillaris layer showed dark areas corresponding to a shadowing effect of retinal lesions and flow voids corresponding to focal ischemia. During follow‐up, there was a partial reperfusion of the retinal layers and the choriocapillaris with persistence of ischemic areas. Conclusions OCTA clearly visualizes ischemic changes in the retinal layers and in the choriocapillaris in hypertensive chorioretinopathy. During follow‐up, OCTA showed incomplete reperfusion of the retinal layers and the choriocapillaris.