This is a fundoscopic photograph of a middle aged cat who presented for vision loss, PU/PD, and decreased appetite. Both eyes had similar lesions. What are the lesions depicted by the arrows and the “xx”? What is the likely cause of these lesions, and what diagnostic tests should be run?
The arrows depict regions of intraretinal hemorrhage, while the XX depicts a large region of retinal detachment. In cats, the most common cause of these lesions is systemic hypertension. As systemic blood pressure increases, serum and eventually blood begin to leak from choroidal blood vessels into the sub-sensory-retinal space. Continued accumulation of these fluids causes separation of the sensory retina from the pigmented epithelium, thus causing retinal detachment and vision loss.
A complete physical exam should be done, and initial diagnostic tests should include measurement of systemic blood pressure, chemistry, CBC, and urinalysis. Additional tests may be ordered based on initial lab results, and/or general physical exam findings.
With appropriate treatment, the ocular lesions from systemic hypertension may reverse and vision may be restored. Early diagnosis and treatment offer the best chance at vision recovery, while long standing detachment and extensive hemorrhage give a more guarded prognosis.