The eye in accelerated hypertension. I. Elschnig's spots in nonhuman primates.

The acute form of Elschnig's spots was produced in a rhesus monkey with experimentally induced accelerated hypertension. Clinically, Elschnig's spots appeared within 24 hours of hypertension as discrete, whitish, subretinal lesions located in the temporal posterior poles of both fundi. The lesions leaked fluorescein. Morphologically, they consisted of complete obstruction of terminal choroidal arterioles and choriocapillaris by fibrin thrombi, necrosis of the retinal pigment epithelium, and fibrinous exudation into Bruch's membrane and into the subpigment epithelial and subretinal spaces. Most of the neurosensory retina was spared from morphologic damage. The differential susceptibility between choroidal and retinal vessels is explained by differences in anatomy and in autonomic nervous control.