Hypertensive Retinopathy Flashcards
What is hypertensive retinopathy?
Describes damage to the small blood vessels in the retina relating to systemic HT
Causes of hypertensive retinopathy?
Can be a result of chronic HT
Can develop quickly in response to malignant HT
Signs occurring in retina in response to HT?
- Silver wiring/copper wiring
- Arteriovenous nipping
- Cotton wool spots
- Hard exudates
- Retinal haemorrhages
- Papilloedema
What is silver/copper wiring?
When the walls of the arterioles become thickened & sclerosed causing increased reflection of light on exam
What is arteriovenous nipping?
Arterioles cause compression of veins where they cross over.
This is due to sclerosis & hardening of the arterioles
What are cotton wool spots and hat causes them?
Caused by ischaemia & infarction in retina causing damage to nerve fibres
What are hard exudates and their cause?
Leaked lipids on the retina
Caused by damaged vessels which lead to the lipids leaking out
What are the cause of retinal haemorrhages and what are they?
Caused by damaged vessels rupturing & releasing blood into retina
Cause and description of papilloedema?
Caused by ischaemia to optic nerve resulting in nerve swelling and blurring of the optic margins
What is the classification of hypertensive retinopathy?
Keith Wagner Classification
Stages of the Keith Wagner classification?
Stage 1: Mild narrowing of arteries
Stage 2: Focal constriction of blood vessels and AV nicking
Stage 3: Cotton wool patches, exudates and haemorrhages
Stage 4: Papilloedema
Management of hypertensive retinopathy?
Focused on controlling BP and other RFs eg smoking and blood lipid levels
