Patient: 59 years of age, BCVA 0,5pp at OD, 0.8 at OS, IOP 16/ 14 mmHg, relative afferent pupillary defect at OD. Ocular Medical History: acute blurry vision in the right eye. General Medical History: Arterial hypertension with blood pressure of 240/ 160 mmHg. Purpose: to present hypertensive choroidopathy with Elschnig spots in arterial hypertension. Methods: Colour Photography Posterior Segment, OCT, Indocyanine Green Angiography. Findings: Colour Photography Posterior Segment: hypopigmented lesions (Elschnig spots), retinal edema, narrowed arterioles, arterio-venous crossing, no retinal hemorrhages. Indocyanine Green Angiography, after 2 min: multifocal areas with choriocapillaris non-perfusion. Mosaic Image: Colour Photography Posterior Segment & Indocyanine Green Angiography: hypopigmented lesions (Elschnig spots areas) corresponding with areas of choriocapillaris non-perfusion. OCT: focal thickening of retinal nerve fiber layer, intraretinal irregularities, no serous retinal detachment. Discussion: Ocular manifestations of systemic hypertension are common and result in vascular compromise at the level of the retina, the choroid, or the optic nerve. Hypertensive choroidopathy is caused by fibrinoid necrosis of the choroidal arterioles. Hypertensive choroidopathy is characterized by hypoperfusion of the choriocapillaris, break down of the retinal pigment epithelial cells, and hypopigmented lesions (Elschnig spots). Hypertensive choroidopathy is a complication of systemic hypertension and can be the harbinger of a life-threatening hypertensive emergency. Literature: (1) Konstantinidis L, Guex-Crosier Y. Hypertension and the eye.Curr Opin Ophthalmol. 2016 Nov;27(6):514-521. (2) Stacey AW, Sozener CB, Besirli C. Hypertensive emergency presenting as blurry vision in a patient with hypertensive chorioretinopathy. Int J Emerg Med. 2015 Apr 23;8:13.