EC Ophthalmology

Purpose: To describe a case of hypertensive retinopathy associated to pheochromocytoma in a 13-year-old female initially treated for infectious neuroretinitis.

Methods: An observational case report. The multimodal images are shown and a review of the literature is done.

Results: We present the multimodal images and results of a 13-year-old female with initial diagnosis of neuroretinitis, that ended having hypertensive retinopathy cause by pheochromocytoma.

Conclusion: Pheochromocytoma, although infrequently at younger age, could cause hypertensive retinopathy that may resemble, initially, neuroretinitis.

Keywords: Hypertensive Retinopathy; Pheochromocytoma; Neuroretinitis; Macular-Star

1. Wong TY., et al. “Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case-control study”. Ophthalmology5 (2003): 933-940.
2. Pamporaki C., et al. “Characteristics of Pediatric vs Adult Pheochromocytomas and Paragangliomas”. The Journal of Clinical Endocrinology and Metabolism 4 (2017): 1122-1132.
3. Januszewicz P., et al. “Pheochromocytoma in children: difficulties in diagnosis and localization”. Clinical and Experimental Hypertension 4 (1990): 571-579.
4. Wyszyńska T., et al. “A single pediatric center experience with 1025 children with hypertension”. Acta Paediatrica 3 (1992): 244-246.
5. Fonkalsrud EW. “Pheochromocytoma in childhood”. Progress in Pediatric Surgery 26 (1991): 103-111.
6. Pham TH., et al. “Pheochromocytoma and paraganglioma in children: a review of medical and surgical management at a tertiary care center”. Pediatrics 3 (2006): 1109-1117.
7. Neumann HP., et al. “Germ-line mutations in nonsyndromic pheochromocytoma”. The New England Journal of Medicine 19 (2002): 1459-1466.
8. Neumann HPH., et al. “Pheochromocytoma and Paraganglioma”. The New England Journal of Medicine 6 (2019): 552-565.
9. Neumann HP., et al. “Germ-line mutations in nonsyndromic pheochromocytoma”. The New England Journal of Medicine 19 (2002): 1459-1466.
10. Waguespack SG., et al. “A current review of the etiology, diagnosis, and treatment of pediatric pheochromocytoma and paraganglioma”. The Journal of Clinical Endocrinology and Metabolism 5 (2010): 2023-2037.
11. Baguet JP., et al. “Circumstances of discovery of phaeochromocytoma: a retrospective study of 41 consecutive patients”. European Journal of Endocrinology 5 (2004): 681-686.
12. Pomares FJ., et al. “Differences between sporadic and multiple endocrine neoplasia type 2A phaeochromocytoma”. Clinical Endocrinology 2 (1998): 195-200.
13. Walther MM., et al. “Clinical and genetic characterization of pheochromocytoma in von Hippel-Lindau families: comparison with sporadic pheochromocytoma gives insight into natural history of pheochromocytoma”. The Journal of Urology 3-1 (1999): 659-664.
14. Rogers BM., et al. “Small intraretinal haemorrhage as the initial manifestation of pheochromocytoma”. Acta Ophthalmologica 4 (2013): 385-387.
15. Gaines SR. “Ocular changes in pheochromocytoma, with a note on its mimicry of optic neuritis”. American Journal of Ophthalmology 4 (1959): 471-487.
16. Berradi S., et al. “Phaeochromocytoma revealed by a stellate neuroretinitis”. The Lancet Diabetes and Endocrinology 8 (2014): 676.
17. Lenders JW., et al. “Phaeochromocytoma”. Lancet 9486 (2005): 665-675.
18. Breffeilh LA and Robinson JP. “The ocular manifestations of pheochromocytoma”. Southern Medical Journal 58 (1965): 73-75.
19. Hervás Ontiveros A., et al. “Bilateral hypertensive retinopathy diagnostic of pheochromocytoma”. Archivos de la Sociedad Española de Oftalmología 3 (2015): 148-149.
20. Petkou D., et al. “Severe bilateral hypertensive retinopathy and optic neuropathy in a patient with pheochromocytoma”. Klinische Monatsblätter für Augenheilkunde 5 (2008): 500-503.
21. Tibbetts MD., et al. “Hypertensive retinopathy in a child caused by pheochromocytoma: identification after a failed school vision screening”. Journal of American Association for Pediatric Ophthalmology and Strabismus 1 (2012): 97-99.