Ophthalmologic Manifestations Revealing Posterior Reversible Encephalopathy Syndrome: A Case Report

Posterior reversible encephalopathy syndrome (PRES) is a rare clinico-radiological syndrome, secondary to many diseases especially high blood pressure. First described by Hinchey in 1996, pathophysiology is not clear. Clinical manifestations are headache, seizures, altered mental state such as confusion or coma, and also visual disturbances, such as hemianopia, blurred vision, diplopia, or cortical blindness. We report the case of a Moroccan 47-years old patient who arrived at the ophthalmology emergency presenting a sudden vision loss and horizontal diplopia, associated with headache. General examination found a high blood pressure at 240/110mmhg. The funduscopy of both eyes found hypertensive retinopathy. A brain MRI was realized showing bilateral occipital cortex T2/fluid-attenuated inversion recovery (FLAIR) hyperintensities. The diagnosis of Posterior reversible encephalopathy syndrome was retained.