It is damage to the retina and the retinal circulation (Blood vessels) due to systemic hypertension (i.e. high blood pressure). The patients with hypertensive retinopathy will present with virtually no visual symptoms till profound vision loss. They usually report with headache or blurred vision. Hypertension can also damage the choroidal circulation and is responsible for optic and cranial neuropathies. Hypertension may also present in the form of subconjunctival haemorrhages.
Systemic hypertension is defined as a systolic pressure greater than 140 mm Hg or a diastolic pressure greater than 90 mm Hg. Most ocular abnormalities are associated with systolic blood pressures greater than 160 mm Hg. Hypertension affects all organs in body where small blood vessels are there like Retina and Kidney. Smaller blood vessels bear the most brunt of raised blood pressure. Diffuse arteriolar narrowing is characteristic of hypertensive retinopathy, this is secondary to vascular constriction in acute hypertension and due to raised cholesterol in chronic hypertension.
Stage 0: Patient has diagnosed hypertension There are no visible retinal vascular abnormalities
Stage 1: Diffuse arteriolar narrowing is seen, especially in the smaller vessels. Arteriolar calibre is uniform, with no focal constriction
Stage 2: Arteriolar narrowing is more pronounced, and there can be focal areas of arteriolar constriction
Stage 3: Focal and diffuse arteriolar narrowing is more obvious and severe Retinal haemorrhages may be present
Stage 4: All the previously listed abnormalities may be present, along with retinal oedema, hard exudates, and optic disc oedema
Hypertension does not only cause Retinopathy but also associated with several other types of manifestation like Branch Retinal vein/artery occlusion, Central Retinal vein/artery occlusion, Optic disc edema and Macular star in in severe hypertension particularly in young Hypertensives, Pregnant females with malignant Hypertension called as Pre-eclampsia and Eclampsia. The latter two may also develop Exudative Retinal Detachment.
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