Steinegger K, Bergin C, Guex-Crosier Y
Jules-Gonin Eye Hospital, University of Lausanne, Switzerland (Chairman: Professor Francine Behar-Cohen).
Klin Monbl Augenheilkd. 2015 Apr;232(4):590-2. doi: 10.1055/s-0034-1396333. Epub 2015 Apr 22.
Malignant hypertension is defined by marked systemic arterial hypertension with retinal haemorrhages, exudation or papilloedema. Due to the rarity of this disease and due to its non-specific symptoms and lesions, the diagnosis can be challenging. Patients and Methods We investigated the types of symptoms and ocular lesions observed with ocular fundus examination, ocular fundus photography, fluorescein angiography and optical coherence tomography in a small case series of 7 patients with malignant hypertension.
Median systolic blood pressure (BP) was 205 mmHg±21. Median diastolic BP was 150 mmHg±16. Decrease in visual acuity (6/7 patients) and scotoma (5/7) were the main symptoms and Elschnig spot, flamed shaped haemorrhage, serous retinal detachment, cotton wool spots and optic nerve oedema were the five most frequently observed lesions. A regression of lesions was observed after therapy of systemic hypertension.
The association of multiple lesions strongly suggests malignant hypertension. However even in cases with only one lesion malignant hypertension should be kept in mind.
恶性高血压的定义为显著的全身性动脉高血压伴有视网膜出血、渗出或视乳头水肿。由于该疾病罕见，且症状和病变不具特异性，诊断颇具挑战性。患者与方法：我们对一小系列7例恶性高血压患者进行了研究，通过眼底检查、眼底摄影、荧光素血管造影和光学相干断层扫描观察症状和眼部病变类型。
收缩压中位数为205 mmHg±21，舒张压中位数为150 mmHg±16。视力下降（7例患者中的6例）和暗点（7例中的5例）是主要症状，Elschnig斑、火焰状出血、浆液性视网膜脱离、棉絮斑和视神经水肿是最常观察到的五种病变。全身性高血压治疗后病变出现消退。
多种病变同时出现强烈提示恶性高血压。然而，即使仅有一个病变的病例也应考虑到恶性高血压。
