A Case Report of Proliferative Hypertensive Retinopathy

Introduction Hypertension affects millions of people worldwide and hypertensive retinopathy is a well-known complication. Retinal findings include arteriolar narrowing, hemorrhages, hard exudates, and cotton wool spots. Retinal neovascularization from malignant hypertension is extremely rare, with only a few cases reported in the literature. Case Report A 40-year-old male was seen as an inpatient at a comprehensive rehabilitation center with a history of malignant hypertension secondary to primary hyperaldosteronism from an aldosterone-producing adenoma. The patient experienced a hemorrhagic stroke from uncontrolled chronic hypertension. Dilated examination revealed hypertensive retinopathy with retinal neovascularization. Detailed history and extensive systemic and ophthalmic workup failed to reveal an alternative cause for retinal proliferation aside from malignant hypertension. Conclusion Proliferative hypertensive retinopathy is a rare finding secondary to extensive retinal ischemia from malignant hypertension. It is important to recognize this uncommon complication as it can lead to significant vision loss.