It is damage to the retina and the retinal circulation (Blood vessels) due to systemic hypertension (i.e. high blood pressure). Patients with hypertensive Retinopathy will present with virtually no visual symptoms till profound vision loss. They usually report with headaches 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 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 the body where small blood vessels are there, like Retina and Kidney.
Smaller blood vessels bear the most brunt of raised blood pressure. The 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.
In hypertensive Retinopathy, it is imperative to understand that the only way to treat or control it is by keeping high blood pressure in check. This can be achieved by bringing drastic changes in daily lifestyles like:
As mentioned above, symptoms of hypertensive retinopathy stages can be controlled by bringing healthy and positive life changes. In addition, if you want to take allopathy treatment, it is best to get in touch with a doctor who might suggest medications like calcium channel blockers, beta-blockers, angiotensin-2 receptor blockers (ARBs), ACE inhibitors, thiazide diuretics, and more to lower your high blood pressure levels.
In addition, with other effects, all these medications can also help the retina to heal while ensuring that no further damage takes place. While prescribing the required medication under hypertensive retinopathy treatment, the doctor will also consider the patient’s medical history while taking all the possible side effects into consideration.
Below we have mentioned 5 hypertensive retinopathy stages:
The patient has been diagnosed with Hypertension. There are no visible retinal vascular abnormalities.
In this hypertensive retinopathy stage, diffuse arteriolar narrowing is seen, especially in the smaller vessels. Arteriolar calibre is uniform, with no focal constriction.
Arteriolar narrowing is more pronounced, and there can be focal areas of arteriolar constriction.
Focal and diffuse arteriolar narrowing is more obvious, and severe Retinal haemorrhages may be present.
In this last hypertensive retinopathy stage, all the previously listed abnormalities may be present, along with retinal oedema, hard exudates, and optic disc oedema.
Patients of hypertensive Retinopathy are vulnerable to several health-related complications like:
Hypertension does not only cause Retinopathy but is 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 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.
In the medical sector, hypertensive retinopathy grading happens across four stages or categories. This division is done via hypertensive retinopathy classification system known as Keith Wegener Barker grades.
In silver wiring hypertensive Retinopathy, when there is thickening and chronic vascular wall hyperplasia, which gives off a reflection similar to silver.
The diagnosis of hypertensive Retinopathy is based on fundoscopic features since it is asymptomatic in most cases. Below we have briefly mentioned three signs of Htn retinopathy:
Hypertensive Retinopathy does not show any clear signs or symptoms unless the situation deteriorates extensively. Below are some of the may symptoms of hypertensive Retinopathy:
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