What is a clinical sign of hypertensive chorioretinopathy?

• A. Dilated, poorly or nonresponsive pupils
• B. Clear cornea
• C. Normal fundus
• D. Improved vision

Answer: (A)

Hypertensive chorioretinopathy occurs with severely elevated blood pressure that affects the retinal circulation and optic nerve, leading to signs such as retinal hemorrhages, cotton-wool spots, exudates, and sometimes papilledema. In the setting of a hypertensive emergency, autonomic or optic nerve dysfunction can manifest as a dilated, poorly reactive pupil. This makes the pupil finding a plausible clinical sign of the condition, supporting the choice.

The other options don’t fit typical hypertensive chorioretinopathy: a clear cornea isn’t related to retinal vascular changes; a normal fundus would not reflect hypertensive damage; and improved vision would be unlikely in acute ocular involvement from severe hypertension.