Hypertensive retinopathy complicated with bilateral retinal neovascularization: PRP versus intravitreal anti-VEGF treatment

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To report a case of hypertensive retinopathy with bilateral retinal neovascularization treated with anti-VEGF intravitreal injection in one eye and panretinal photocoagulation (PRP) in the fellow eye.


A 33-year-old male patient presented with gradual visual loss in both eyes for the last five months. From his medical history, idiopathic systematic hypertension was diagnosed five months ago. There was no other relevant medical or family history. Best corrected visual acuity (BCVA) was CF in the right eye and 8/10 in the left eye. Anterior segment examination was unremarkable on both eyes. Fundus examination showed abnormalities in both eyes compatible with hypertensive retinopathy and extensive areas of neovascularization. OCT examination showed no evidence of macular oedema. Fluorescein angiography (FFA) revealed macular ischaemia in the right eye and large areas of retinal ischemia and retinal neovascularization with vascular leakage, mainly across the temporal arcades, in both eyes. Indocyanine green angiography (ICG) showed no further pathology. Patient was treated with an anti-VEGF (ranibizumab) intravitreal injection in the right eye and PRP laser in the left eye.


Follow up examination one and two months post-operatively showed no change in BCVA in either eye. FFA documented regression of retinal neovascularization mainly in the right, while in the left eye there were still areas of vascular leakage across the temporal arcades.


Hypertensive retinopathy can be rarely complicated with retinal neovascularization.

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