Ophthalmology - Hypertensive Retinopathy Flashcards
What is hypertensive retinopathy?
Damage to the small blood vessels in the retina relating to hypertension
How can changes in hypertensive retinopathy occur?
Slowly with chronic hypertension or quickly in response to malignant hypertension
What are the features of hypertensive retinopathy?
Silver wiring or copper wiring
Arteriovenous nipping
Cotton wool spots
Hard exudates
Retinal haemorrhages
Papilloedema
What is silver wiring or copper wiring in hypertensive retinopathy?
Thickening and sclerosing of arterioles that reflect more light on examination
What is arteriovenous nipping?
Compression of veins by arterioles due to sclerosis and hardening
What causes cotton wool spots in the retina?
Ischaemia and infarction causing damage to nerve fibres
What causes hard exudates in hypertensive retinopathy?
Leaking lipids from damaged vessels onto the retina
What are retinal haemorrhages?
Rupturing of damaged vessels releasing blood in the retina
What are dot and blot haemorrhages?
Haemorrhages occurring deeper in the inner nuclear layer or outer plexiform layer
What are flame haemorrhages?
Haemorrhages occurring in the nerve fiber layer
What is papilloedema?
Swelling of the optic nerve caused by ischaemia
What is the Keith-Wagener Classification?
Used to stage hypertensive retinopathy
Stage 1 - Mild narrowing of arterioloes
Stage 2 - Focal constriction of blood vessels and AV nicking
Stage 3 - Cotton-wool patches, exudates and haemorrhages
Stage 4 - Papilloedema
What is the primary focus of management for hypertensive retinopathy?
Controlling blood pressure and managing risk factors
