Severe bilateral hypertensive retinopathy and optic neuropathy in a patient with pheochromocytoma.
BACKGROUND
We present a case of severe bilateral hypertensive retinopathy and optic neuropathy due to pheochromocytoma.


METHODS
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.


RESULTS
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.
Petkou
D
D
Department of Ophthalmology, General Hospital of Patras 'O Agios Andreas', Patras, Greece.
Petropoulos
I K
IK
Kordelou
A
A
Katsimpris
J M
JM
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000175:diagnosis*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology*; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis*