{"id":3538,"date":"2018-11-02T15:08:22","date_gmt":"2018-11-02T15:08:22","guid":{"rendered":"http:\/\/blog.neoretina.com\/?p=3538"},"modified":"2019-12-30T09:53:30","modified_gmt":"2019-12-30T09:53:30","slug":"hypertensive-retinopathy-the-more-you-know-the-better","status":"publish","type":"post","link":"https:\/\/neoretina.com\/blog\/hypertensive-retinopathy-the-more-you-know-the-better\/","title":{"rendered":"Hypertensive Retinopathy: The more you know, the better"},"content":{"rendered":"

Hypertension or increased blood pressure is a common yet serious problem affecting millions of people worldwide. Both acute and chronic hypertensive changes occur in the eyes.<\/p>\n

The acute changes manifest due to malignant hypertension while the chronic changes from systemic, long-term hypertension.<\/p>\n

Introduction to Vascular Damage<\/h2>\n

The retina of the eye acts as a window to the crucial circulatory system. Blood vessels present in the retina mimic coronary (of the heart) and cerebral (of the brain) microcirculation. Doctors can easily examine and inspect retinal blood vessels. With such examination, early signs of high blood pressure, diabetes, and other diseases can be detected.<\/p>\n

Due to high blood pressure, the walls of the retinal blood vessels thicken. It causes the lumen of the blood vessels to become narrow and restrict the blood flow reaching the retina. Over a period of time, hypertension can limit the functioning of the retina by damaging the blood vessels and by putting excessive pressure on the optic nerve. Eventually, it causes vision problems. Thus, retinal vascular damage due to high blood pressure causes a condition known as \u2018Hypertensive retinopathy\u2019.<\/p>\n

Links to hypertension and cardiovascular complications<\/h3>\n

Acute hypertension leads to reversible vasoconstriction in the blood vessels of retina while hypertensive crisis can cause optic disc edema. Prolonged elevated blood pressure causes several vascular changes. Thus, hypertension is linked as a risk factor for retinal disorders including hypertensive retinopathy.<\/p>\n

Also, raised blood pressure is associated with stroke, other cardiovascular complications and damage to systemic target organs. Signs and symptoms of hypertensive retinopathy are linked with congestive heart failure and coronary heart disease. Its signs are associated with ischemic changes.<\/p>\n

Indicator of target organ damage<\/h3>\n

Poorly controlled blood pressure affects many vital systems of the body including the renal, cardiovascular and the retina. Any damage to these important systems is called \u2018target-organ damage\u2019. When hypertension affects retina of the eye, hypertensive retinopathy occurs.<\/p>\n

Hypertension does not impair vision. However, hypertensive retinopathy may cause blockage of arteries or veins supplying blood to the retina. This may result in blindness. Hypertensive retinopathy patients are at greater risk of developing hypertensive damage to several other end organs. Thus, it is one of the key indicators of such target organ damage.<\/p>\n

About the silent killer that is growing<\/h3>\n

Hypertensive retinopathy is basically a retinal vascular damage which is caused by elevated blood pressure. This makes hypertension the \u2018silent killer\u2019 as the clinical signs of organ damage appear very late in the disease. Hence, it becomes important to refine risk stratification approach to ensure detection of hypertension-related hypertensive retinopathy or end organ damage before the signs cause symptoms.<\/p>\n

Symptoms to look for<\/strong>
\nThe signs and symptoms of hypertensive retinopathy do not develop until late in this disease. Generally, it includes visual field defects or blurred vision. Funduscopic examination in the early stages can identify vascular wall changes such as arteriolar constriction, changes in arterio-venous crossings etc.<\/p>\n

If the hypertension is chronic or poorly controlled, it can cause:<\/p>\n