Hypertensive Retinopathy

Question 1

What is hypertensive retinopathy?

Answer 1

Retinal damage caused by chronic or acute hypertension.

Question 2

What are the key stages of hypertensive retinopathy?

Answer 2

Mild, moderate, and severe, based on Keith-Wagener-Barker classification.

Question 3

What is the pathophysiology of hypertensive retinopathy?

Answer 3

Chronic hypertension causes arteriosclerosis, while acute hypertension leads to vascular leakage and ischaemia.

Question 4

What are the clinical signs of mild hypertensive retinopathy?

Answer 4

Arteriolar narrowing, arteriovenous (AV) nicking, and copper or silver wiring.

Question 5

What is arteriovenous (AV) nicking?

Answer 5

Compression of veins by stiffened arterioles at crossing points.

Question 6

What are the clinical signs of moderate hypertensive retinopathy?

Answer 6

Retinal haemorrhages, cotton wool spots, and hard exudates.

Question 7

What are cotton wool spots?

Answer 7

White patches on the retina caused by microinfarctions of the retinal nerve fibre layer.

Question 8

What are the clinical signs of severe hypertensive retinopathy?

Answer 8

Papilloedema, extensive retinal haemorrhages, and exudative retinal detachment.

Question 9

What is the significance of papilloedema in hypertensive retinopathy?

Answer 9

Indicates malignant hypertension and requires urgent medical intervention.

Question 10

What systemic conditions are associated with hypertensive retinopathy?

Answer 10

Chronic hypertension, malignant hypertension, and pre-eclampsia/eclampsia.

Question 11

What are the symptoms of hypertensive retinopathy?

Answer 11

It is often asymptomatic but can cause blurred vision, headaches, or visual field defects in severe cases.

Question 12

How is hypertensive retinopathy diagnosed?

Answer 12

Fundoscopic examination showing characteristic retinal changes.

Question 13

What is the role of fundoscopy in hypertensive retinopathy?

Answer 13

Identifies retinal changes such as haemorrhages, exudates, and papilloedema.

Question 14

What are the risk factors for hypertensive retinopathy?

Answer 14

Chronic hypertension, poor blood pressure control, smoking, diabetes, and hyperlipidaemia.

Question 15

What are the complications of untreated hypertensive retinopathy?

Answer 15

Retinal vein or artery occlusion, optic neuropathy, and permanent vision loss.

Question 16

What is the Keith-Wagener-Barker classification?

Answer 16

A system used to grade hypertensive retinopathy from grade 1 (mild) to grade 4 (severe).

Question 17

How is hypertensive retinopathy managed?

Answer 17

Controlling systemic blood pressure and managing cardiovascular risk factors.

Question 18

What medications are used to treat hypertension in patients with hypertensive retinopathy?

Answer 18

Antihypertensives such as ACE inhibitors, calcium channel blockers, or diuretics.

Question 19

What is the relationship between hypertensive retinopathy and cardiovascular disease?

Answer 19

Hypertensive retinopathy indicates end-organ damage and is associated with an increased risk of cardiovascular events.

Question 20

What investigations are performed in hypertensive retinopathy?

Answer 20

Blood pressure measurement, renal function tests, lipid profile, and fundoscopy.

Question 21

What is the role of optical coherence tomography (OCT) in hypertensive retinopathy?

Answer 21

OCT can detect macular oedema or subtle retinal changes.

Question 22

What is the prognosis for hypertensive retinopathy with treatment?

Answer 22

Retinal changes may improve with effective blood pressure control, but advanced damage may be permanent.

Question 23

What are hard exudates, and how do they form?

Answer 23

Yellow deposits of lipid and protein in the retina due to chronic vascular leakage.

Question 24

Why is hypertensive retinopathy a marker of systemic hypertension severity?

Answer 24

Retinal changes reflect the extent of vascular damage throughout the body.

Question 25

Why is urgent referral required for malignant hypertensive retinopathy?

Answer 25

To prevent life-threatening complications such as stroke, heart failure, or renal failure.