High blood pressure retinopathy

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If left untreated, high blood pressure can lead to complications in many other organs such as the heart, brain, kidneys, blood vessels, etc. Similar to diabetes, high blood pressure can cause damage to small blood vessels. in the retina. High blood pressure can cause blockage of blood vessels in the eye, bleeding in the eye, papilledema... affecting the patient's vision.
Vascular manifestations in the retina indirectly reflect vascular changes and damage in organs such as the heart, kidney, and brain because the vascular structure of these organs is similar. In fact, clinicians can base on retinal changes to assess the extent and response to treatment of hypertension.
In the early stages, retinopathy does not affect vision much, so it is easy to ignore. In the later stages, when there are serious injuries and complications on the retina, the eyes will be blurred, difficult to treat and difficult to recover.

1. Retinopathy due to hypertension

1.1 Arterial narrowing This is a manifestation of increased vascular pressure. In severe hypertension, precapillary arterioles are blocked, forming a soft, cottony discharge.

1.2 Vessel wall leak Causes candle-shaped retinal hemorrhages, retinal edema, and hard exudates that form macular stars. If malignant hypertension can cause optic disc edema

1.3 Arterial sclerosis Changes the cross section between the artery and the vein. Although it does not indicate the severity of hypertension, it does reflect the duration of hypertension.

2. Choroidal disease

Choroidal occlusion: manifested by Elschnig nodules.

Siegrist streak: hyperpigmented streak along the scleral vessels, common in malignant hypertension.

Retinal detachment: seen in persistent malignant hypertension, pregnancy toxicity.

2. Optic neuropathy

Optic disc edema, periapical hemorrhage.

4. Stages of hypertensive retinopathy

Stage I : Arterioles miniaturization

Stage II: miniature arterioles, venous deviation at the
cross section

Stage III:
Small arterioles like copper wire. Salus Gunn's sign: TM shrinks the tip of the tip, deviating at right angles to the cross section of the artery. Accompanied by candle-shaped hemorrhage, soft discharge, and hard discharge.

Stage IV : includes stage III with small artery like silver wire and papilledema.

5. Imaging tests of the eye

Color fundus photography to assess lesions Fluorescein angiography: assess ischemic areas, leaky vessels... Optical retinal tomography: to diagnose and evaluate macular damage, exudative retinal detachment.

6. Complications of hypertensive retinopathy

Occlusion of central retinal vein Occlusion of central retinal artery Occlusion of optic nerve optic nerve ophthalmoplegia Paralysis of oculomotor...