Hypertensive Retinopathy

Question 1

What is Chronic Hypertension?

Answer 1

Grade 1 Disease:
The changes of early Hypertensive Retinopathy are subtle, with generalised arteriolar narrowing.

Grade 2 Disease:
Development of areas of focal narrowing, and compression of venules at sites of arteriovenous crossing (AV nipping).

Grade 3 Disease:
Development of features similar to those of DR like Retinal haemorrhages, Hard Exudates and Cotton Wool Spots.

Question 2

What is Malignant Hypertension?

Answer 2

Presents with Grade 4 Hypertensive Retinopathy, which includes all the features of Grade 3, with the addition of Optic Disc Swelling.

Question 3

What are Other Features of Malignant Hypertension?

Answer 3

• Headaches
• Eye pain
• Reduced visual acuity
• Focal Neurological Deficits

Question 4

What is the treatment for Hypertensive Retinopathy?

Answer 4

Antihypertensives and Emergency Hospital Admission

Question 5

Macular Star

Answer 5

Macular star is associated with Hypertensive Retinopathy.

It is a ring of exudates around the macula.

Question 6

Hypertensive Retinopathy

Answer 6

That associated with essential Hypertension; changes may include irregular narrowing of the retinal arterioles, haemorrhages in the nerve fibre layers and the outer plexiform layer, exudates and cotton-wool patches, arteriosclerotic changes, and, in malignant hypertension, papilledema.