SEARCH RESULTS FOR: chronic-hypertensive-retinopathy-pathogenesis-and-clinical-findings

chronic-hypertensive-retinopathy-pathogenesis-and-clinical-findings

Chronic Hypertensive Retinopathy: Pathogenesis and clinical findings 
Risk Factors for 1° HTN (ex. 1` Age, FHx, Ethnicity, Diet, Smoking, 1` Alcohol use, Stress, 1` Salt intake, 1` BMI, 1, Exercise) • 1° HTN 
Retinal Detachment 
Vitreous Hemorrhage 
Central/Branch Retinal Artery/Vein Occlusions 
Risk Factors for 2° HTN (ex. Hyperaldosterone, Cushing's, Acromegaly, Chronic Kidney Disease, Obstructive Sleep Apnea, Diabetes Mellitus, Hypo/Hyper-thyroid, Adrenal Hyperplasia, Renal Artery Stenosis) 
2° HTN 
Ophthalmic Artery Hypertension ,17 
Stage 1: Mild/vasoconstrictive 
Stage 2: Moderate/sclerotic 
Stage 3: Severe/exudative 
Stage 4: Malignant 
Abbreviations: • HTN — Hypertension • BRB — Blood-retinal barrier • RPE — Retinal pigment epithelium 
Legend: 
Pathophysiology 
Mechanism 
Acute and chronic vasospasm 


Authors: Graeme Prosperi-Porta Reviewers: Stephanie Cote Usama Malik Johnathan Wong* * MD at time of publication 
Diffuse and focal arterial  narrowing and vascular tortuosity 
Atherosclerosis and hyalinization causes arteriolar wall thickening resulting in a diffuse light reflex appearing red-brown coloured 
Thickening of the arteriolar wall and/or sclerotic thickening at the arteriole/venule crossing compresses the underlying venule 
BRB breakdown causes dot/blot hemorrhages in the inner retina and flame hemorrhages in the nerve fiber layer 
Serum proteins and lipids leakage from damaged BRB appears as white or yellow areas with sharp margins 
Occlusion of the terminal retinal arterioles causes fluffy white ischemic lesions in the inner retinal nerve fiber layer 
Hyper-pigmented patches surrounded by a hypo-pigmented ring due to RPE clumping around atrophic areas in the choroid 
Sign/Symptom/Lab Finding 
lschemia of optic disc arterioles causes optic nerve swelling and blurred disc margins. Leakage of optic disc arterioles causes hemorrhage and disc edema. 
Complications 
Copper Wiring 
AV nicking 
Retinal  Hemorrhages 
Yellow Hard Exudates  
Cotton-wool Spots  
Elschnig's Spots  
Papilledema