Hypertensive Retinopathy Flashcards
What is hypertensive retinopathy?
Hypertensive retinopathy describes the damage to the small blood vessels in the retina relating to systemic hypertension. This can be the result of years of chronic hypertension or can develop quickly in response to malignant hypertension. There are a number of signs that occur within the retina in response to the effects of hypertension in these vessels.
What is silver wiring/ copper wiring?
Silver wiring or copper wiring is where the walls of the arterioles become thickened and sclerosed causing increased reflection of the light.
What is arteriovenous nipping?
Arteriovenous nipping is where the arterioles cause compression of the veins where they cross. This is again due to sclerosis and hardening of the arterioles.
What are cotton wool spots?
Cotton wool spots are caused by ischaemia and infarction in the retina causing damage to nerve fibres.
What are hard exudates?
Hard exudates are caused by damaged vessels leaking lipids into the retina.
What are retinal haemorrhages?
Retinal haemorrhages are caused by damaged vessels rupturing and releasing blood into the retina.
What is papilloedema?
Papilloedema is caused by ischaemia to the optic nerve resulting in optic nerve swelling (oedema) and blurring of the disc margins.
Briefly describe the anatomy of the normal fundus
What are the signs of hypertensive retinopathy on fundoscopy?
- Silver wiring or copper wiring
- Ateriovenous nipping
- Cotton wool spots
- Hard exudates
- Retinal haemorrhages
- Pappiloedema
Briefly describe Keith-Wagener Classification
Stage 1: Mild narrowing of the arterioles
Stage 2: Focal constriction of blood vessels and AV nicking
Stage 3: Cotton-wool patches, exudates and haemorrhages
Stage 4: Papilloedema
Briefly describe the management of hypertensive retinopathy
Management is focused on controlling the blood pressure and other risk factors such as smoking and blood lipid levels.
