hypertensive retinopathy

Question 1

what is hypertensive retinopathy?

Answer 1

involves damage to small blood vessels in retina due to prolonged HTN

Question 2

how can HTN retinopathy progress?

Answer 2

chronic HTN - slow
malignant HTN - quickly

Question 3

what features can be seen within HTN retinopathy?

Answer 3

silver wiring/ copper wiring
ateriovenous nipping
cotton wool spots
hard exaduates
retinal haemorrhages
papilledema

Question 4

what is silver wiring/ copper wiring?

Answer 4

walls of arterioles become thickened and sclerosed and reflect more light on examination

Question 5

what is arteriovenous nipping?

Answer 5

AV nipping - arterioles cause compression of veins where they cross due to sclerosis and hardening of arterioles

Question 6

what causes cotton wool spots?

Answer 6

ischaemia and infarction of retina - damage to nerve fibres

Question 7

what are hard exudates?

Answer 7

damaged vessels leaking lipids onto retina

Question 8

what 2 types of retinal haemorrhages can be caused by HTN retinopathy?

Answer 8

retinal haemorrhages - damaged vessels rupturing and releasing blood
dot and blot
flame haemorrhage

Question 9

what is a dot and blot haemorrhage?

Answer 9

deeper haemorrhage within inner nuclear layer or outer plexiform layer

Question 10

what are flame haemorrhages?

Answer 10

haemorrhage within nerve fibre layer

Question 11

what causes papilloedema?

Answer 11

ischaemia to optic nerve resulting in optic nerve swelling

Question 12

how do you manage HTN retinopathy?

Answer 12

controlling BP
managing RF - smoking, blood lipids