Hypertensive choroidopathy with eclampsia viewed on spectral-domain optical coherence tomography

We report a case of hypertensive choroidopathy with detailed retinal images obtained using spectral-domain optical coherence tomography (SD-OCT). A 19-year-old pregnant woman with no history of high blood pressure had an eclamptic seizure at the 39th week of pregnancy; the baby was delivered by emergency Caesarean section. Six days later, she presented with bilateral blurred vision (best-corrected visual acuity [VA], 0.5, right eye; 0.3, left eye). Bilateral extensive, punctate, pale-yellow Elschnig's spots were present in the posterior fundus. SD-OCT showed a serous retinal detachment (SRD) and retinal pigment epithelium detachment (PED) representing a waveform retinal pigment epithelium (RPE) layer in each eye. The reflective intensity decreased partly at the waveform RPE. A wavy structure suggestive of fibrin was present in both foveas between the photoreceptor ellipsoid zone and the RPE-outer segment line. Four weeks after delivery and oral antihypertensive treatment, the SRDs, PEDs and wavy structure resolved and the VA recovered. SD-OCT visualized SRDs, PEDs, wavy structures under the photoreceptor ellipsoid zone, and areas of low intensity RPE layer in hypertensive choroidopathy.