Hypertensive Retinopathy

Hypertensive retinopathy is a retinal vascular damage caused by high blood pressure. Complaints develop normally late in the disease process. The Funduscopic study shows arteriolar vasoconstriction, crossing phenomena, vessel wall changes, flame-shaped haemorrhages, cotton wool spots, yellow hard exudates and papilledema. Treatment is aimed at controlling blood pressure and vision loss occurring on the retina.

Hypertensive retinopathy is a retinal vascular damage caused by high blood pressure. Complaints develop normally late in the disease process. The Funduscopic study shows arteriolar vasoconstriction, crossing phenomena, vessel wall changes, flame-shaped haemorrhages, cotton wool spots, yellow hard exudates and papilledema. Treatment is aimed at controlling blood pressure and vision loss occurring on the retina. Pathophysiology An acute increase in blood pressure typically leads to reversible vasoconstriction in retinal blood vessels, and hypertensive crisis may cause papilledema. A longer existing or severe hypertension results in exudative vascular changes, which are a result of endothelial damage and necrosis. Other changes (eg. As wall thickening of the arterioles, crossing phenomena) are developing increased blood pressure usually over years. By smoking, the adverse effects of hypertensive retinopathy worse. Hypertension is a major risk factor for other retinal diseases (e.g., retinal vein or artery occlusion example, diabetic retinopathy). In addition, an increased hypertension associated with diabetes mellitus, the risk of vision loss significantly. Patients with hypertensive retinopathy have a high risk of hypertensive damage to other organs. Symptoms and discomfort symptoms develop normally until late in the disease process, and include blurred vision, or visual field defects. In early stages in funduscopy is seen a arteriolar constriction, with a reduction of the ratio of the width of the retinal arteriole to retinal venules. Chronic, poorly controlled high blood pressure causes the following: Permanent artery stenosis arteriovenous crossing abnormalities (crossing phenomena) Arteriosclerosis with moderate vascular wall changes (copper wire arteries) to heavier vessel wall hyperplasia and thickening (silver wire arteries) Sometimes complete vascular occlusion occurs. Crossing phenomena are an essential predisposition for the development of Branch Retinal Vein Occlusion. When the acute illness is severe, to the following may develop: Superficial flame-shaped hemorrhages Small, white, superficial foci of retinal ischemia (Cotton-wool spots) yellow hard exudates papilloedema Yellow hard exudates mean intraretinal lipid deposits from leaking retinal vessels. This exudate can form a star shape in the macula, especially if the hypertension is severe. For severe hypertension of the optic nerve head is clogged and edematous (papilledema have hypertensive crisis notwithstanding). Diagnosis Diagnosis is made by medical history (duration and severity of hypertension) and fundoscopy. Hypertensive retinopathy (copper wire arteries) Image courtesy of Prof. J. Wollensak via the Online Journal of Ophthalmology (www.onjoph.org). var model = {thumbnailUrl: ‘/-/media/manual/professional/images/hypertensive_retinopathy_copper_wiring_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/hypertensive_retinopathy_copper_wiring_high_de.jpg?la = en & thn = 0 ‘, title:’ Hypertensive retinopathy (copper wire arteries) ‘description:’ u003Ca id = “v37894309 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eVerengungen the retinal arterioles by thickening and clouding of the Arteriolenwände (copper wire artery) due to a hypertensive arteriosclerosis. In the picture is also a macular edema seen u003c / p u003e u003c / div u003e ‘credits’. Image courtesy of Prof. J. Wollensak via the Online Journal of Ophthalmology (www.onjoph.org) . ‘

Health Life Media Team

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