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Last additions - Hypertensive Retinopathy - Cotton Wool Spots and Elschnig Spots and Optic Disc Edema - Malignant Hypertension 56-year-old man was seen in the office on March 11, 2013. He was hospitalized for five days a few weeks ago for increased high blood pressure. He said when he was hospitalized he is not sure, but his systolic blood pressure was in the high 200s and the diastolic pressure was in the mid 100s. His vision is reasonable in both eyes. He is not noticing any pain or discomfort. VISUAL ACUITY: OD 20/25, OS 20/20. IOP: 9 OU. SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are 2+ cotton wool spots on the macula. OS: Vertical C/D ratio is 0.1. There is 1+ optic nerve edema and 2+ cotton wool spots. SPECTRALIS-SD-OCT SCAN: The nerve fiber layer scan shows thickening of the nerve fiber layer in both eyes. The average thickness in the right eye is 109 microns with thickening of the superior and inferior pole. The left eye has 133 microns with thinning of the superior, but thickening of the inferior pole of the nerve. COLOR PHOTOS: The photos show the cotton wool spots in the macula of both eyes. IMPRESSION: 1. HYPERTENSIVE RETINOPATHY – BOTH EYES WITH COTTON WOOL SPOTS AND OPTIC NERVE EDEMA DISCUSSION: I explained to the patient that he does have manifestations of hypertensive retinopathy in both eyes. Generally when the blood pressure is controlled, the retina normalizes, but he may end up with a little bit of optic atrophy depending on how severe the ischemic insult to the eye was. I asked him to return for a check in six weeks so I can repeat some of the testing.
Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 767 views6 week fu - CWS are FadingApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 682 viewsNerve Swelling is lessApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema (NFL Scan - Black Line this visit, Gray line 6 weeks ago)795 viewsNerve Swelling is LessApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 711 views6 week fu - CWS are FadingApr 25, 2013
Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 781 views6 week fu - CWS are FadingApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1082 views6 week fu - CWS are FadingApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1948 viewsElschnig SpotsApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 2064 viewsElschnig SpotsApr 25, 2013
Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1539 viewsElschnig Spots are pigment spots in peripheryApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1234 viewsElschnig Spots are pigment spots in peripheryApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1064 views6 week fu - CWS are FadingApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 975 views6 week fu - CWS are FadingApr 25, 2013
Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 756 viewsMacular Scan Shows Cotton Wool Spots and Nerve Swelling (on Left)Apr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 841 viewsApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1013 viewsApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1126 viewsApr 25, 2013
Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1206 viewsApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1322 viewsApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1354 viewsApr 25, 2013	Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1546 viewsApr 25, 2013
Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 1580 viewsApr 25, 2013
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56-year-old man was seen in the office on March 11, 2013. He was hospitalized for five days a few weeks ago for increased high blood pressure. He said when he was hospitalized he is not sure, but his systolic blood pressure was in the high 200s and the diastolic pressure was in the mid 100s. His vision is reasonable in both eyes. He is not noticing any pain or discomfort. VISUAL ACUITY: OD 20/25, OS 20/20. IOP: 9 OU. SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are 2+ cotton wool spots on the macula. OS: Vertical C/D ratio is 0.1. There is 1+ optic nerve edema and 2+ cotton wool spots. SPECTRALIS-SD-OCT SCAN: The nerve fiber layer scan shows thickening of the nerve fiber layer in both eyes. The average thickness in the right eye is 109 microns with thickening of the superior and inferior pole. The left eye has 133 microns with thinning of the superior, but thickening of the inferior pole of the nerve. COLOR PHOTOS: The photos show the cotton wool spots in the macula of both eyes. IMPRESSION: 1. HYPERTENSIVE RETINOPATHY – BOTH EYES WITH COTTON WOOL SPOTS AND OPTIC NERVE EDEMA DISCUSSION: I explained to the patient that he does have manifestations of hypertensive retinopathy in both eyes. Generally when the blood pressure is controlled, the retina normalizes, but he may end up with a little bit of optic atrophy depending on how severe the ischemic insult to the eye was. I asked him to return for a check in six weeks so I can repeat some of the testing.