A Case of Optic Disc Edema and Macular Star

Öz

Malignant hypertension may cause many ocular symptoms such as focal arteriolar contraction, cotton-wool spots, macular edema, retinal hemorrhages, hyperpigmented spots, optic disc edema, macular stars. Malignant hypertension should not be forgotten in a patient with optic disc edema and macular star even if the patient does not use anti-hypertensive drugs. Here a case of vision loss due to malignant hypertension induced optic disc edema and macular star was presented.

Malignant hypertension may cause many ocular symptoms such as focal arteriolar contraction, cotton-wool spots, macular edema, retinal hemorrhages, hyperpigmented spots, optic disc edema, macular stars. Malignant hypertension should not be forgotten in a patient with optic disc edema and macular star even if the patient does not use anti-hypertensive drugs. Here a case of vision loss due to malignant hypertension induced optic disc edema and macular star was presented

Anahtar Kelimeler

• macular star
• malignant hypertension
• neuroretinitis
• optic disk edema

Bir Olguda Optik Disk Ödemi ve Makülar Yıldız Görünümü

Öz

Malign hipertansiyon fokal arteriol daralması, cotton-wool spotlar, maküla ödemi, retinal kanamalar, hiperpigmente spotlar, optik disk ödemi, makülar yıldız görünümü gibi birçok oküler bulguya neden olabilir. Optik disk ödemi ve makülar yıldız görünümü ile gelen bir hastada antihipertansif ilaç kullanmıyor olsa bile malign hipertansiyon unutulmamalıdır. Bu yazıda malign hipertansiyona bağlı optik disk ödemi ve makülar yıldız gelişmesi nedeniyle görme kaybına yol açan bir olgu sunuldu.Hipertansiyon dünyada önlenebilir ölüm nedenleri arasında birinci sırada olup günümüzde yetişkin nüfusun yaklaşık %31,8’ini etkilemektedir (1). Malign hipertansiyon ilk kez 1928 de Keith ve ark. tarafından retinit, belirgin tansiyon yüksekliği ve renal fonksiyon bozukluğunu kapsayan bir tablo olarak tariflenmiştir (2).

Anahtar Kelimeler

• makülar yıldız
• malign hipertansiyon
• nöroretinit
• optik disk ödemi

Kaynakça

1. Altun B, Arici M, Nergizoğlu G, Derici U, Karatan O, Turgan C, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23:1817-23.
2. Keith NM, Wagener HP, Kernohan JW. The syndrome of malignant hypertension. Arch Intern Med. 1928;41:141-88.
3. Mitchell RN, Schoen FJ. Blood vessels. In: Kumar, Abbas & Fausto, et al (Editors). Robbins and Cotran Pathologic Basis of Disease. Philadelphia, Pennsylvania, USA: Saunders Elsevier, 2010; 487–528.
4. Richard JG. Current therapy in nephrology and hypertension. The CV Mosby Company, 1984-1985; 324-333.
5. Hayreh SS, Servais GE, Virdi PS. Fundus lesions in malignant hypertension. IV. Focal intraretinal
6. periarteriolar transudates. Ophthalmology. 1986;93:60-73.
7. Murphy HP, Chew EY. Hypertension: In: Ryan SJ, Schachat AP, Murphy RP, Pätz A, (Editors). Retina. St Louis: The Mosby Company, 1989: 449-455.
8. Lee AG, Beaver HA. Acute bilateral optic disc edema with macular star figure in a 12-year-old girl. Surv Ophthalmol. 2002;47:42-9.

9. Leavitt JA, Pruthi S, Morgenstern BZ. Hypertensive retinopathy mimicking neuroretinitis in a twelve-year-old girl. Surv Ophthalmol. 1997;41:477-81.
10. Parlak I, Parlak M, Erdur B, Kuru O, Turkcuer I, Ayrik C. Sudden painless visual loss after initiation of antihypertensive therapy: case report. Eur J Emerg Med. 2007;14:354-5.