Hypertensive Retinopathy Flashcards
What is hypertensive retinopathy?
Retinal damage caused by chronic or acute hypertension.
What are the key stages of hypertensive retinopathy?
Mild, moderate, and severe, based on Keith-Wagener-Barker classification.
What is the pathophysiology of hypertensive retinopathy?
Chronic hypertension causes arteriosclerosis, while acute hypertension leads to vascular leakage and ischaemia.
What are the clinical signs of mild hypertensive retinopathy?
Arteriolar narrowing, arteriovenous (AV) nicking, and copper or silver wiring.
What is arteriovenous (AV) nicking?
Compression of veins by stiffened arterioles at crossing points.
What are the clinical signs of moderate hypertensive retinopathy?
Retinal haemorrhages, cotton wool spots, and hard exudates.
What are cotton wool spots?
White patches on the retina caused by microinfarctions of the retinal nerve fibre layer.
What are the clinical signs of severe hypertensive retinopathy?
Papilloedema, extensive retinal haemorrhages, and exudative retinal detachment.
What is the significance of papilloedema in hypertensive retinopathy?
Indicates malignant hypertension and requires urgent medical intervention.
What systemic conditions are associated with hypertensive retinopathy?
Chronic hypertension, malignant hypertension, and pre-eclampsia/eclampsia.
What are the symptoms of hypertensive retinopathy?
It is often asymptomatic but can cause blurred vision, headaches, or visual field defects in severe cases.
How is hypertensive retinopathy diagnosed?
Fundoscopic examination showing characteristic retinal changes.
What is the role of fundoscopy in hypertensive retinopathy?
Identifies retinal changes such as haemorrhages, exudates, and papilloedema.
What are the risk factors for hypertensive retinopathy?
Chronic hypertension, poor blood pressure control, smoking, diabetes, and hyperlipidaemia.
What are the complications of untreated hypertensive retinopathy?
Retinal vein or artery occlusion, optic neuropathy, and permanent vision loss.
What is the Keith-Wagener-Barker classification?
A system used to grade hypertensive retinopathy from grade 1 (mild) to grade 4 (severe).
How is hypertensive retinopathy managed?
Controlling systemic blood pressure and managing cardiovascular risk factors.
What medications are used to treat hypertension in patients with hypertensive retinopathy?
Antihypertensives such as ACE inhibitors, calcium channel blockers, or diuretics.
What is the relationship between hypertensive retinopathy and cardiovascular disease?
Hypertensive retinopathy indicates end-organ damage and is associated with an increased risk of cardiovascular events.
What investigations are performed in hypertensive retinopathy?
Blood pressure measurement, renal function tests, lipid profile, and fundoscopy.
What is the role of optical coherence tomography (OCT) in hypertensive retinopathy?
OCT can detect macular oedema or subtle retinal changes.
What is the prognosis for hypertensive retinopathy with treatment?
Retinal changes may improve with effective blood pressure control, but advanced damage may be permanent.
What are hard exudates, and how do they form?
Yellow deposits of lipid and protein in the retina due to chronic vascular leakage.
Why is hypertensive retinopathy a marker of systemic hypertension severity?
Retinal changes reflect the extent of vascular damage throughout the body.
Why is urgent referral required for malignant hypertensive retinopathy?
To prevent life-threatening complications such as stroke, heart failure, or renal failure.
