Hypertensive Retinopathy

Question 1

What is hypertensive retinopathy?

Answer 1

Damage to small blood vessels in the retina due to systemic hypertension

Question 2

What can be seen on hypertensive retinopathy?

Answer 2

Silver/copper wiring
Arteriovenous nipping
Cotton wool spots
Hard exudates
Retinal haemorrhages
Papilloedema

Question 3

What is silver/copper wiring?

Answer 3

Where walls of the arterioles become thickened and sclerosed causing increased reflection of light

Question 4

What is arteriovenous nipping?

Answer 4

Where the arterioles cause compression of the veins where they cross

Question 5

What are cotton wool spots?

Answer 5

White spots due to ischaemia and infarction causing damage to nerve fibres

Question 6

What are hard exudates?

Answer 6

Caused by damaged vessels leaking lipids into the retina

Question 7

What are retinal haemorrhages?

Answer 7

Damaged vessels rupture and release blood into retina

Question 8

What is papilloedema?

Answer 8

Optic nerve swelling and blurring of disc margins cased by ischaemia to optic nerve

Question 9

What classification system is used for hypertensive retinopathy?

Answer 9

Keith-Wagener

Question 10

What is the Keith-Wagener classification?

Answer 10

Stage 1 - mild narrowing of arterioles

Stage 2 - focal constriction of blood vessels and AV nicking

Stage 3 - cotton-wool patches, exudates + haemorrhages

Stage 4 - papilloedema

Question 11

How is hypertensive retinopathy managed?

Answer 11

BP control

Vascular risk factor modification