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Elschnig’s spots, an atypical sign of target organ damage
  1. Ivan Eduardo Cabrales-Escobar1,
  2. Myrna Leticia Luevano-González2
  1. 1 Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
  2. 2 Ophthalmology, Hospital Nuestra Señora de la Luz, Mexico City, Mexico
  1. Correspondence to Dr Ivan Eduardo Cabrales-Escobar, Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; ivan_cabrales92{at}

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A 42-year-old woman with arterial hypertension and end-stage kidney disease presented to the emergency department for acute dyspnoea and headache. Her blood pressure was 210/130 mmHg. Chest X-ray showed pulmonary oedema, for which the diagnosis of hypertensive emergency was made. She was treated with intravenous nitroglycerin and furosemide, showing improvement. At discharge she was referred to ophthalmology for visual acuity of 20/50 in both eyes. Fundus examination revealed hypertensive retinopathy and Elschnig’s spots (figures 1 and 2) predominantly in temporal quadrants (figure 3).

Figure 1

Ultra-widefield colour photograph of the fundus showing vascular tortuosity (arrow), arteriovenous crossings (circle), silver wiring (white arrowhead) and Elschnig’s spots (black arrowhead).

Figure 2

Red-free fundus photograph …

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  • Contributors IECE and MLLG contributed equally to this work. All authors contributed to clinical care of the patient, wrote and reviewed the manuscript and approved its final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.