Bilateral Disc Swelling and Exudative Retinal Detachment as Presenting Signs of Hypertensive Chorioretinopathy

To report a case of hypertensive chorioretinopathy.

A 31-year-old man was referred with the complaint of blurred vision and severe headache 1 month ago. Bilateral disc swelling and exudative retinal detachment, as well as scattered yellow lesions, were evident below the retina. Multiple lumbar punctures with the suspicion of idiopathic intracranial hypertension (IIH) and methyl prednisolone pulse therapy with the diagnosis of Vogt-Koyanagi-Harada (VKH) disease had been performed for him during the last month. A very high blood pressure (BP) was detected for the patient and his visual acuity and headache improved after urgent and intensive BP control.

Hypertensive chorioretinopathy may be misdiagnosed as IIH, ocular inflammation, or other disorders because of the overlap between the presenting signs, but it should be thought of as the first differential diagnosis due to its life-threatening nature.