Multimodal Imaging of Elschnig Spots: A Case of Simultaneous Hypertensive Retinopathy, Choroidopathy, and Neuropathy.

A 65-year-old woman with chronic hypertension, chronic renal insufficiency, and schizophrenia self-discontinued her medications and presented complaining of decreased vision; she was found to have a blood pressure of 256/156 and visual acuity 20/70 OD. In the emergency department, her blood pressure was rapidly lowered to a nadir of 134/104. During the course of her hospitalization, her visual acuity declined from 20/70 to 20/200 OD in parallel with a decline in her renal function. Multi-modal imaging revealed simultaneous hypertensive retinopathy, choroidopathy, and optic neuropathy. Autofluorescence can play an important role in the diagnosis of hypertensive choroidopathy.