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Information about Hypertensive Retinopathy

Hypertensive retinopathy
Classification & external resources
ICD-10H35.0
ICD-9362.11
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 vision or headaches.

Signs

Signs of damage to the retina caused by hypertension include:
  • 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 arterioles 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
  • Ischemic changes (e.g. "cotton wool spots")
  • Hemorrhages, often flame shaped.
  • Edema
  • Ring of exudates around the retina called a "macular star"
  • Papilledema, or optic disc edema, in patients with malignant hypertension
  • Visual acuity loss, typically due to macular involvement

Diagnosis

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

References

  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease, J.B. Lippincott, 1994.
  • Hypertensive retinopathy




 •  • [ e]
Pathology of the eye (primarily , )
Eyelid, lacrimal system and orbitStye - Chalazion - Blepharitis - Entropion - Ectropion - Lagophthalmos - Blepharochalasis - Ptosis - Xanthelasma - Trichiasis - Dacryoadenitis - Epiphora - Exophthalmos - Enophthalmos
ConjunctivaConjunctivitis - Pterygium - Pinguecula - Subconjunctival hemorrhage
Sclera and corneaScleritis - Keratitis - Corneal ulcer - Snow blindness - Thygeson's superficial punctate keratopathy - Fuchs' dystrophy - Keratoconus - Keratoconjunctivitis sicca - Arc eye - Keratoconjunctivitis - Corneal neovascularization - Kayser-Fleischer ring - Arcus senilis - Band keratopathy
Iris and ciliary bodyIritis - Uveitis - Iridocyclitis - Hyphema - Persistent pupillary membrane
LensCataract - Aphakia
Choroid and retinaChorioretinitis - Retinal detachment - Retinoschisis - Retinopathy (Hypertensive retinopathy, Diabetic retinopathy, Retinopathy of prematurity) - Macular degeneration - Retinitis pigmentosa - Retinal haemorrhage - Central serous retinopathy - Macular edema - Epiretinal membrane - Macular pucker
Optic nerve and visual pathwaysOptic neuritis - Papilledema - Optic atrophy
Ocular muscles,
binocular movement,
accommodation and refraction		Paralytic strabismus: Ophthalmoparesis - Progressive external ophthalmoplegia - Palsy (III, IV, VI) - Kearns-Sayre syndrome Other strabismus: Esotropia/Exotropia - Hypertropia - Heterophoria (Esophoria, Exophoria) - Brown's syndrome - Duane syndrome
Other binocular: Conjugate gaze palsy - Convergence insufficiency - Internuclear ophthalmoplegia - One and a half syndrome
Refractive error: Hyperopia/Myopia - Astigmatism - Anisometropia/Aniseikonia - Presbyopia
Visual disturbances and blindnessAmblyopia - Leber's congenital amaurosis - Subjective (Asthenopia, Hemeralopia, Photophobia, Scintillating scotoma) - Diplopia - Scotoma - Anopsia (Binasal hemianopsia, Bitemporal hemianopsia, Homonymous hemianopsia, Quadrantanopia) - Color blindness (Achromatopsia) - Nyctalopia - Blindness/Low vision
PupilAnisocoria - Argyll Robertson pupil - Marcus Gunn pupil/Marcus Gunn phenomenon - Adie syndrome
Infectious diseasesTrachoma - Onchocerciasis
OtherNystagmus - Miosis - Mydriasis - Glaucoma - Floater - Leber's hereditary optic neuropathy - Red eye - Keratomycosis - Xerophthalmia - Aniridia
For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
..... Click the link for more information.
List of ICD-10 codes. The version for 2007 is available online at [1]

Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
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For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. These codes are in the public domain.

See also


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For the moth genus, see Retina (moth).


The retina is a thin layer of neural cells that lines the back of the eyeball of vertebrates and some cephalopods. It is comparable to the film in a camera.
..... Click the link for more information.
Blood pressure (strictly speaking: vascular pressure) refers to the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs.
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Hypertension
Classification & external resources

ICD-10 I 10. ,I 11. ,I 12. ,
I 13. ,I 15.
ICD-9 401.x

OMIM 145500
DiseasesDB 6330
MedlinePlus 000468
eMedicine med/1106   ped/1097 emerg/267


..... Click the link for more information.
The blood vessels are part of the cardiovascular system and function to transport blood throughout the body. The most important types, arteries and veins, carry blood away from or towards the heart, respectively.
..... Click the link for more information.
Eyes are organs of vision that detect light. Different kinds of light-sensitive organs are found in a variety of organisms. The simplest eyes do nothing but detect whether the surroundings are light or dark, while more complex eyes can distinguish shapes and colors.
..... Click the link for more information.
In psychology, visual perception is the ability to interpret visible light information reaching the eyes which is then made available for planning and action. The resulting perception is also known as eyesight, sight or vision.
..... Click the link for more information.
Headache
Classifications and external resources

ICD-10 R 51.
ICD-9 784.0

A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache.
..... Click the link for more information.
Simply, a sign is an indication of some fact or quality; and, in everyday English, a medical sign is an "objective" indication of some medical fact or quality that is detected by a physician during a physical examination of a patient—such as elevated
..... Click the link for more information.
Atherosclerosis
Classification & external resources

Changes in endothelial dysfunction in atherosclerosis (note text comments about geometry error)
ICD-10 I 70.
..... Click the link for more information.
An arteriole is a small diameter blood vessel that extends and branches out from an artery and leads to capillaries.

Arterioles have thin muscular walls (usually only one to two layers of smooth muscle) and are the primary site of vascular resistance[1].
..... Click the link for more information.
Sclerosis or sclerotization is a hardening of tissue

In medicine

  • multiple sclerosis, a central nervous system disease which affects coordination
  • hippocampal sclerosis, a brain damage often seen in individuals with temporal lobe epilepsy

..... Click the link for more information.
In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply
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Cotton wool spots are an abnormal finding on fundoscopic exam of the retina. They appear as puffy white patches on the retina. They are caused by damage to nerve fibers. The nerve fibers are damaged by swelling in the surface layer of the retina.
..... Click the link for more information.
Bleeding, technically known as hemorrhage (American English) or haemorrhage (British English) is the loss of blood from the circulatory system.[1] Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either
..... Click the link for more information.
Edema
Classifications and external resources

ICD-10 R 60.9
ICD-9 782.3

DiseasesDB 9148

This page is about the medical condition. For the rock band, see Adema.

..... Click the link for more information.
An exudate is any fluid that filters from the circulatory system into lesions or areas of inflammation. Its composition varies but generally includes water and the dissolved solutes of the blood, some or all plasma proteins, white blood cells, platelets and (in the case of local
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macula or macula lutea (from Latin macula, "spot" + lutea, "yellow") is an oval yellow spot near the center of the retina of the human eye. It has a diameter of about 1.5 mm and is often histologically defined as having two or more layers of ganglion cells.
..... Click the link for more information.
Papilledema
Classification & external resources

ICD-10 H 47.1
ICD-9 377.0

DiseasesDB 9580

eMedicine oph/187  
MeSH D010211 Papilledema (or papilloedema
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The optic disc or optic nerve head is the location where ganglion cell axons exit the eye to form the optic nerve. There are no light sensitive rods or cones to respond to a light stimulus at this point thus it is also known as "the blind spot" or "anatomical blind
..... Click the link for more information.
Edema
Classifications and external resources

ICD-10 R 60.9
ICD-9 782.3

DiseasesDB 9148

This page is about the medical condition. For the rock band, see Adema.

..... Click the link for more information.
MeSH D006974 Malignant hypertension is a complication of hypertension characterized by very elevated blood pressure, and organ damage in the eyes, brain, lung and/or kidneys. It differs from other complications of hypertension in that it is accompanied by papilledema.
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Visual acuity (VA) is acuteness or clearness of vision, especially form vision, which is dependent on the sharpness of the retinal focus within the eye, the sensitivity of the nervous elements, and the interpretative faculty of the brain.
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Fluorescein angiography, or fluorescent angiography, is a technique for examining the circulation of the retina using the dye tracing method. It involves injection of sodium fluorescein into the systemic circulation, and then an angiogram is obtained by photographing the
..... Click the link for more information.
The ophthalmoscope is an instrument used to examine the eye. Its use is crucial in determining the health of the retina and the vitreous humor.

In patients with headaches, the finding of swollen optic discs, or papilledema, on ophthalmoscopy is a key sign, as this indicates
..... Click the link for more information.
A sphygmomanometer (often condensed to sphygmometer [1] ) or blood pressure meter is a device used to measure blood pressure, comprising an inflatable cuff to restrict blood flow, and a mercury or mechanical manometer to measure the pressure.
..... Click the link for more information.
A hypertensive emergency is severe hypertension with acute impairment of an organ system (especially the central nervous system, cardiovascular system and/or the renal system) and the possibility of irreversible organ-damage.
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