Hypertensive retinopathy

Question 1

What is the first stage of the Keith-Wagener classification of hypertensive retinopathy?

Answer 1

Arteriolar narrowing and tortuosity
Increased light reflex - silver wiring

Stage I features indicate early signs of hypertensive changes in the retina.

Question 2

What are the key features of Stage II in the Keith-Wagener classification?

Answer 2

Arteriovenous nipping

Stage II indicates more advanced changes in the retinal vasculature.

Question 3

What features characterize Stage III of the Keith-Wagener classification?

Answer 3

Cotton-wool exudates
Flame and blot haemorrhages
These may collect around the fovea resulting in a ‘macular star’

Stage III is indicative of significant retinal damage due to hypertension.

Question 4

What is the defining feature of Stage IV in the Keith-Wagener classification?

Answer 4

Papilloedema

Stage IV represents the most severe form of hypertensive retinopathy with optic disc swelling.

Question 5

Fill in the blank: Stage I of the Keith-Wagener classification includes increased light reflex known as _______.

Answer 5

silver wiring

This term refers to the shiny appearance of narrowed arterioles.

Question 6

True or False: Stage III hypertensive retinopathy includes features such as cotton-wool exudates and papilloedema.

Answer 6

False

Papilloedema is a feature of Stage IV, not Stage III.

Question 7

List the features of Stage I in the Keith-Wagener classification.

Answer 7

• Arteriolar narrowing and tortuosity
• Increased light reflex - silver wiring

These features indicate initial changes in the retinal vasculature.

Question 8

List the features of Stage III in the Keith-Wagener classification.

Answer 8

• Cotton-wool exudates
• Flame and blot haemorrhages
• ‘Macular star’

These changes reflect more severe retinopathy due to hypertension.