Question of the Week

For July 16, 2019

A 30-year-old man is evaluated for headache and blurred vision. He has been aware for several years that he has hypertension, but he has not taken any medication consistently and has not kept his follow-up appointments. He has a strong family history of hypertension. His current blood pressure is 245/125 mm Hg in both arms. His neurologic examination is unremarkable.

Which one of the following funduscopy findings would be most concerning in this patient?

Optic disk swelling
Arteriovenous nicking
Optic atrophy
Macular edema