Hypertensive Retinopathy

Question 1

What is HTN retinopathy?

Answer 1

Damage to the small blood vessels of the retina due to systemic HTN

Question 2

Features of HTN retinopathy

Answer 2

• Silver/Copper wiring where the walls of the arterioles become thickened leading to increased reflection of light
• AV nipping where arterioles cause compression of the veins
• Cotton wool spots caused by ischaemia of retina
• Hard exudates of lipids
• Retinal haemorrhages
• Papilledema caused by ischaemia to the optic nerve

Question 3

What is the Keigh-Wagener Classification?

Answer 3

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: Papilledema

Question 4

What is the management of HTN retinopathy?

Answer 4

• Control BP and minimise risk factors