Bilateral Optic Disc Edema from Hypertensive Retinopathy

A 29 year-old woman was assessed for 2 weeks of headaches and 4 days of blurred vision in both eyes. Her blood pressure was 225/135. Her examination showed: best-corrected visual acuity: 20/25 OD, 20/30 OS; pupils equal and reactive without relative afferent pupillary defect; intraocular pressures 16 OU; full color vision OU; full ocular motility OU. Her fundus examination showed bilateral optic disc edema with retinal hemorrhages, tortuous veins, attenuated arteries, cotton wool spots, and exudates OU, consistent with grade 4 hypertensive retinopathy. Intravenous fluorescein angiography (IVFA) showed prominent late leakage consistent with true bilateral disc edema.EEChypertensiveretinopath