Hypertensive choroidopathy with bilateral serous retinal detachment as the presenting finding in malignant hypertension

Background Secondary hypertension, particularly in young patients, can manifest as malignant hypertension with ocular complications. We report a case of hypertensive choroidopathy with serous retinal detachment as the initial presentation of malignant hypertension in a young woman with renal failure secondary to antimalarial treatment. Case Presentation: A 19-year-old woman with a history of renal failure following antimalarial treatment treatment presented with sudden, bilateral vision loss (right eye: 20/200, left eye: 20/40). Fundus examination revealed asymmetrical choroidal involvement with serous retinal detachment, more pronounced in the right eye. Her blood pressure was markedly elevated at 230/130 mmHg. Following blood pressure control with the patient's vision improved to 20/20 in both eyes, and the serous retinal detachments resolved completely. Conclusion This case highlights the importance of considering hypertensive choroidopathy in young patients with secondary hypertension presenting with sudden vision loss. Prompt diagnosis and blood pressure management can lead to complete visual recovery.