VEGF-A and VEGF-Ax: bad protein and good protein.

involvement, mainly in the right eye, with abundant exudation and intraretinal edema (Fig. 1A). Due to suspected acute hypertensive retinopathy caused by hypertensive crisis, arterial pressure (AP) was taken, 230/150 mmHg with similar values on several readings. The diagnostic of malign arterial hypertension in a patient without known antecedents caused the patient to be referred to internal medicine for urgent medical treatment and secondary hypertension study. Renal magnetic resonance revealed a lesion which depended on the left suprarenal gland, with well defined edges, solid and necrotic-cystic areas which produce a mass-like effect (Fig. 2). 24-h urine analysis for noradrenaline and normetanephrine was positive, with the remaining supplementary tests being negative. With the diagnosis of left pheochromocytoma, surgical resection was decided with laparoscopic adrenalectomy. 3 months later, AP readings returned to normal, VA was 20/20 in both eyes and the exudation, hemorrhages and partial papillary edema progressively disappeared (Fig. 1C). Macular OCT revealed a near complete recovery of the normal foveal profile with progressive subretinal liquid reabsorption (Fig. 1B). In addition, headaches and excessive sweating also disappeared. Malign hypertension can involve hypertensive encephalopathy expressions such as intense headaches, vomit, visual alterations, convulsions or even coma.2 Pheochromocytoma should be considered in differential diagnostics in the presence of said symptoms. In the present case, ophthalmological involvement pointed to a suspicion of hypertension and therefore we consider ocular fundus as a necessary exploration in cases of severe or prolonged cephalea.