Hypertensive Retinopathy

Definition / Overview

Retinal manifestations of systemic hypertension, ranging from mild arteriolar changes to severe retinopathy with disc edema. Hypertension is the strongest systemic risk factor for retinal-arterial-macroaneurysm (present in 75% of RAM cases).

Key Details

  • Classification: Keith-Wagener-Barker or Wong-Mitchell grading systems — details to be added from dedicated source
  • Arteriolar changes: generalized/focal narrowing, AV nicking, copper/silver wiring
  • Retinal signs: flame hemorrhages, cotton-wool spots, hard exudates (macular star)
  • Severe: disc edema (malignant hypertension)
  • Arteriosclerotic changes in vessel walls are the pathological basis for RAM formation — focal ischemia from embolic damage leads to intimal collagen remodeling and vessel dilation

Clinical Relevance

Every patient diagnosed with RAM requires a systemic workup for hypertension. Control of hypertension is the primary prevention strategy for RAM.

Associations

Sources

  • macroaneurysm-eyewiki (mentions hypertension in 75% of RAM; limited detail on hypertensive retinopathy itself)

Gap: This page needs a dedicated source on hypertensive retinopathy classification, staging, and management. Current content is derived only from the RAM article.