FUNDUS FLUORESCEIN ANGIOGRAPHY OF PATIENTS WITH SEVERE HYPERTENSIVE NEPHROPATHY

Purpose: To analyze the fluorescein angiograms of patients with hypert ensive renal failure. Methods: Fluorescein angiograms were obtained of 34 patients with hypertensive renal failure. The glomerular filtratio n was less than 20 ml/min in each patient. Results: Capillary nonperfu sion and a coarse retinal capillary bed are the hallmark of the hypert ensive retinopathy. Tortuous retinal arterioles or tortuous retinal ar teriovenous anastomoses are observed. It is suggested that capillary c ollaterals shunt arteriolar obstructions or short-cut nonperfused capi llary beds; these remodel into tortuous arterioles or arteriovenous an astomoses with regular caliber. Elschnig spots and delayed choroidal f illing are signs of hypertensive choroidopathy. Depigmentation spots o f the retinal pigment epithelium without a central pigment clump are c onsidered atypical Elschnig spots. Conclusions: Retinal pigment epithe lial changes are permanent scars of hypertensive choroidopathy, while coarse retinal capillary bed and tortuous retinal arterioles or arteri ovenous anastomoses are the result of hypertensive retinopathy in thes e patients with hypertensive renal failure.