To compare the findings of fluorescein angiography (FA) and optical coherence tomography angiography in a patient with malignant hypertensive retinopathy.

case report

A 41 year-old male was referred to our clinic with sudden visual loss in his both eyes after an acute rise of blood pressure (120/150 mmHg). The best corrected visual acuity was 20/50 in his right eye and 20/30 in his left eye. Optic disc swelling, flame shape hemorrhage especially around the optic disc, arterial narrowing, vessels tourtousity, cotton wool spot, hard exudates deposition with multiple deep orange spot indicating of Elschnig spot were revealed in both eyes. In fovea imaging, the disruption in normal tapering pattern of superficial and deep capillary networks compatible with ischemic areas and enlargement of foveal avascular zone (FAZ) in deep capillary plexus were obviously observed, however these findings hardly were revealed in FA. The Elschnig spots also clearly were revealed in choriocapillary level as hypo intense spots on OCTA.

It can be concluded that OCTA can illustrate the ischemic area and Elschnig spots with more details and obviously as compared to fluorescein angiography.