THE CORRELATION

BETWEEN HYPERTENSION
AND RETINOPATHY
Yuliani
03008262
INTRODUCTION
Hypertension is worldwide epidemic
The prevalence dramatically increases in patients older than 60 years
Hypertension is associated with cardiovascular risk and systemic target organ damage
Retinopathy is considered as one of the indicators of target organ damage
Acute and chronic hypertension changes may manifest in the eyes
Ocular involvement in the setting of malignant hypertension was first described by
Liebreich, in 1859
HYPERTENSION
Hypertension means
high pressure (tension)
in the arteries.
The silent killer
Causes of hypertension
associated with genetic
factors, obesity, lack of
exercise, overuse of salt,
and aging
Primary
(95%)
caused by a specific
disorder of a particular
organ or blood vessel
Secondary
(5%)
Classification of hypertension
Normal : <120
mmHg for
systolic and
<80 mmHg for
diastolic.
Prehypertensio
n : 120-139
mmHg for
systolic and 80-
89 mmHg for
diastolic.
Stage 1 Hypertension
140-159 (systolic)
or 90-99 (diastolic)
Stage 2 Hypertension
>/=160 (systolic)
or >/=100 (diastolic)
Treatment for hypertension
Lifestyle
adjustment
and diet
Medication
regimens
ACE
inhibitors
ARB
drugs
beta-
blockers
diuretics
Calcium
channel
blocker
Retinopathy
Retinopathy refers to damage to the blood vessels of
the retina. Retinopathy is not caused by
inflammation.
The type of retinopathy is often specified. Diabetic
retinopathy is retinal disease associated with
diabetes. Hypertensive retinopathy is retinal disease
due to high blood pressure.
The treatment of all these retinopathies is confined
to that of the general disease.
The correlation between
hypertension and retinopathy
Hypertensive
retinopathy
damage
to the
blood
vessels
Untreated
hypertension
can affect
your eyesight
Damage
to the
retina
Pathophysiology
Hypertension
Damages the
small blood
vessels in the
retina
Their walls to
thicken
Blood supply to
the retina is
reduced
Patches of the
retina may
become damaged
As hypertensive
retinopathy
progresses
blood may leak
into the retina.
lead to a gradual loss
of vision, particularly
if they affect the
macula
Symptoms
Usually
asymptomatic
May have
decreased
vision
Signs
Chronic, poorly controlled hypertension
causes the following:
Permanent arterial
narrowing
Arteriovenous crossing
abnormalities
(arteriovenous nicking)
Arteriosclerosis with
moderate vascular wall
changes (copper wiring)
Acute disease is severe, the following can
develop:
Superficial flame-shaped
hemorrhages
cotton-wool spots
Yellow hard exudates
Optic disk edema/
papilledema

Hypertensive retinopathy
Copper wiring
Stages of hypertensive retinopathy
(KeithWagener classification)
Stage Signs
I Arteriolar narrowing
Increased light reflex
"Silver wiring"
II Arteriovenous nipping
III Cotton-wool "exudates"
Flame and blot hemorrhages
IV Papilledema
Treatment
If vision loss occurs,
treatment of the
retinal edema with
intravitreal injection
of corticosteroids or
anti-VEGF drugs may
be useful.
By
controlling
hypertensi
on.
Prognosis
Patients with grade 4 (severe hypertensive
retinopathy) often have heart and kidney
complications of high blood pressure. They are
also at higher risk for stroke.
The retina will generally recover if the blood
pressure is controlled. However, some
patients with grade 4 hypertensive
retinopathy will have permanent damage to
the optic nerve or macula.
Conclusion
Hypertension is worldwide epidemic. Untreated
hypertension can also affect your eyesight.
Hypertension can cause damage to the blood vessels
in the retina, this condition is known as hypertensive
retinopathy. Most people with hypertensive
retinopathy do not have symptoms until late in the
disease. With funduscopy we can identify early stage
of hypertensive retinopathy. Treatment for
hypertensive retinopathy is controlling hypertension.
Bibliography
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