Hypertensive retinopathy

Question 1

What is hypertensive retinopathy?

Answer 1

Hypertension causes damage to the retina through arteriolar vasoconstriction and leakage

Question 2

What is the presentation of hypertensive retinopathy?

Answer 2

Blurred vision
Sudden vision loss
Floaters in the visual field

Question 3

What is seen on fundoscopy in severe hypertensive retinopathy?

Answer 3

Cotton-wool spots
Retinal haemorrhages
A ‘macular star’
Papilloedema

Question 4

What are the stages of hypertensive retinopathy?

Answer 4

1 - arteriolar narrowing and tortuosity
2 - arteriovenous nipping
3 - cotton wool exudates and blot haemorrhages
4 - papilloedema

Question 5

What is a ‘macular star’?

Answer 5

Where flame and blot haemorrhages collect around the fovea

Question 6

What are the differentials of hypertensive retinopathy?

Answer 6

Diabetic retinopathy
Retinal vein occlusion
Age-related macular degeneration

Question 7

What investigations can be used in the diagnosis of hypertensive retinopathy?

Answer 7

Fundoscopy
Fluorescein angiography
OCT

Question 8

What is the management of hypertensive retinopathy?

Answer 8

For neovascularisation:
Laser photocoagulation
vEGF inhibitors