Hypertensive Retinopathy.pptx

Hypertensive Retinopathy Grades Colour Fundus Photography Retinal angiography

1. Presenter: Dr. Md. Rezwanul Hasan Long Term Fellow, Vitreo -Retina

2. Hypertension is a risk factor for many systemic conditions that cause serious morbidity and mortality. It affects over 1.13 billion people worldwide. Hypertension can have various effects on the eyes, including the development of retinopathy, choroidopathy, and optic neuropathy. conditions. The most common ocular presentation of hypertension is hypertensive retinopathy. Introduction

3. Constricted and tortuous arterioles. Retinal hemorrhages, hard exudates, and cotton wool spots. Retinal edema and papilledema. Widening of arteriole reflex, arteriovenous crossing signs, and copper/silver wire arterioles.

4. Classification of Hypertensive Retinopathy There are several grading systems proposed to classify its severity, including the Keith-Wagener-Barker classification and the simplified grading system proposed by Wong and Mitchell . These staging systems serves as a valuable tool for documenting the disease's stage and its progression.

5. Diagnosis of Hypertensive Chorioretinopathy Retinal imaging, particularly wide-field color fundus photography, is useful for documenting these findings and assessing for improvement over time. Fluorescein angiography can be helpful in investigating hypertensive chorioretinopathy, showing patchy and delayed choroidal filling, severely delayed retinal arterial filling, and areas of retinal capillary nonperfusion. Indocyanine green (ICG) angiography can demonstrate hypocyanescence of ischemic areas of the choroid.

6. Optical coherence tomography of the macula of the right eye ( A ) and left eye ( B ) of a patient with hypertensive chorioretinopathy shows macular edema and serous retinal detachments. These serous retinal detachments improved after medical management of hypertension.

7. Differential diagnoses for hypertensive chorioretinopathy includes D iabetic retinopathy, radiation retinopathy, anemia and other blood dyscrasias, ocular ischemic syndrome, and retinal vein occlusion. Clinical history and the presence of elevated blood pressure are valuable for distinguishing hypertensive chorioretinopathy from other conditions. 

8. Complications

9. Management of hypertensive retinopathy and choroidopathy

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