Hypertensive retinopathy 247435 203436920 2008-04-05T02:39:14Z 68.149.135.150 {{DiseaseDisorder infobox | Name = Hypertensive retinopathy | ICD10 = {{ICD10|H|35|0|h|30}} | ICD9 = {{ICD9|362.11}} | }} '''Hypertensive retinopathy''' is damage to the [[retina]] due to high [[blood pressure]] (i.e. [[hypertension]]). ==Pathophysiology== The retina is one of the "target organs" that are damaged by sustained hypertension. Subjected to excessively high blood pressure over prolonged time, the small [[blood vessels]] that involve the [[eye]] are damaged, thickening, bulging and leaking. Early signs of retinopathy correlate less well with mortality and morbidity than used to be thought, but signs of accelerated or "malignant" hypertension indicate severe illness. ==Symptoms== Most patients with hypertensive retinopathy present without visual symptoms, however, some may report decreased [[Visual perception|vision]] or [[headache]]s. ==Signs== [[Sign (medicine)|Sign]]s of damage to the retina caused by hypertension include: *[[Arteriosclerosis|Arteriosclerotic]] changes **Arteriolar narrowing that is almost always bilateral ***Grade I - 3/4 normal caliber ***Grade II - 1/2 normal caliber ***Grade III - 1/3 normal caliber ***Grade IV - thread-like or invisible **Arterio-venous crossing changes (aka "[[AV nicking]]") with venous constriction and banking **Arteriolar color changes ***''Copper wire arterioles'' are those [[arteriole]]s in which the central light reflex occupies most of the width. ***''Silver wire arterioles'' are those in which the central light reflex occupies all of the width of the arteriole. **Vessel [[sclerosis]] *[[Ischemia|Ischemic]] changes (e.g. "[[cotton wool spots]]") *[[Hemorrhage]]s, often flame shaped. *[[Edema]] **Ring of [[exudate]]s around the retina called a "[[Macula|macular]] star" *[[Papilledema]], or [[optic disc]] [[edema]], in patients with [[malignant hypertension]] *[[Visual acuity]] loss, typically due to macular involvement ==Diagnosis== *[[Fluorescein angiography]] *[[Ophthalmoscopy]] *[[Sphygmomanometry]] ==Treatment and management== A major aim of treatment is to prevent, limit, or reverse such target organ damage by lowering the patient's high blood pressure. The eye is an organ where damage is easily visible at an early stage, so regular eye examinations are important. ==See also== *[[Hypertensive crisis]] *[[List of eye diseases and disorders]] *[[List of systemic diseases with ocular manifestations]] *[[Ophthalmology]] *[[Optometry]] ==References== *''The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease'', J.B. Lippincott, 1994. *[http://www.opt.indiana.edu/ce/retvasdz/hyper.htm Hypertensive retinopathy] [[Category:Ophthalmology]] [[de:Fundus hypertonicus]] [[pt:Retinopatia hipertensiva]] {{eye-stub}} {{Eye pathology}}