Hypertensive Retinopathy

Question 1

What is hypertensive retinopathy

Answer 1

Damage to retinal blood vessels due to chronic/malignant hypertension

Question 2

Features of hypertensive retinopathy

Answer 2

Fundoscopy:
Silver wiring of arterioles
Arteriovenous nipping
Cotton wool spots due to nerve fibres damage
Hard exudates due to damaged vessels leaking lipids into retina
Retinal haemorrhages
Papilloedema (blurry optic disc) due to ischaemia to optic nerve resulting in optic nerve swelling

Question 3

What’s the Keith Wagner classification?

Answer 3

Grading of hypertensive retinopathy in terms of severity

1: mild narrowing of arterioles
2: focal constriction of blood vessels, AV nicking
3: cotton wool patches, hard exudates, haemorrhages
4: papilloedema

Question 4

Management of hypertensive retinopathy?

Answer 4

Manage BP
Controlling hxn risk factors