Serous retinal detachment in hypertensive posterior reversible encephalopathy syndrome

In accelerated hypertension, vasogenic brain edema associated with PRES may represent either autoregulatory breakthrough leading to vasodilation or excessive autoregulation leading to vasoconstriction. We describe 2 patients with PRES in accelerated hypertension who had serous retinal detachments, a vasoconstrictive phenomenon. The concurrence of serous retinal detachment and PRES offers intriguing support for the idea that vasoconstriction rather than vasodilation is the mechanism of vasogenic edema in PRES.