hrvatski

Hipertenzivna retinopatija

Hypertension is associated with profound, often asymptomatic, multisystemic effects. The eye is not spared the effects of elevated blood pressure. However, the eye is distinctive in that it allows the direct sequelae of elevated blood pressure to be visualized early, particularly changes in the retinal microvasculature. The most well-known effect of the hypertension on the eye is therefore the condition called hypertensive retinopathy. Hypertensive retinopathy refers to a spectrum of retinal microvascular signs that typically include retinal arteriolar narrowing, arteriovenous nicking (AVN), retinal hemorrhages, microaneurysms and, in severe cases, optic disc and macular edema. These signs develop due to acute and chronic elevations in blood pressure. The initial response is diffuse and localized vasospasm of the retinal arterioles with consequent narrowing. Arteriolar narrowing is a defining sign of hypertensive retinopathy and reflects vasoconstriction as an autoregulatory response in an attempt to control the volume of blood received by the retinal capillary bed. If the blood pressure remains chronically elevated, there is compression of venules by structural changes in the arterioles, resulting in arteriovenous nicking. Severe hypertension leads ultimately to progression to an ‘exudative’ stage in which flame-shaped retinal hemorrhages and cotton wool spots are observed, and finally to a ‘malignant’ stage with optic disc and macular edema. The main purpose of screening for hypertensive retinopathy is that retinal vessels are the only blood vessels visible on routine examination. Ophthalmologists and general physicians should work in collaborations to ensure that hypertensive patients are efficiently screened, and timely managed to reduce the risk of ocular and systemic morbidity and mortality. The retinal changes can be halted when hypertension is treated.

hipertenzija, hipertenzivna retinopatija, mikrovaskulatura

nije evidentirano

engleski

Hypertensive retinopathy

Hypertension is associated with profound, often asymptomatic, multisystemic effects. The eye is not spared the effects of elevated blood pressure. However, the eye is distinctive in that it allows the direct sequelae of elevated blood pressure to be visualized early, particularly changes in the retinal microvasculature. The most well-known effect of the hypertension on the eye is therefore the condition called hypertensive retinopathy. Hypertensive retinopathy refers to a spectrum of retinal microvascular signs that typically include retinal arteriolar narrowing, arteriovenous nicking (AVN), retinal hemorrhages, microaneurysms and, in severe cases, optic disc and macular edema. These signs develop due to acute and chronic elevations in blood pressure. The initial response is diffuse and localized vasospasm of the retinal arterioles with consequent narrowing. Arteriolar narrowing is a defining sign of hypertensive retinopathy and reflects vasoconstriction as an autoregulatory response in an attempt to control the volume of blood received by the retinal capillary bed. If the blood pressure remains chronically elevated, there is compression of venules by structural changes in the arterioles, resulting in arteriovenous nicking. Severe hypertension leads ultimately to progression to an ‘exudative’ stage in which flame-shaped retinal hemorrhages and cotton wool spots are observed, and finally to a ‘malignant’ stage with optic disc and macular edema. The main purpose of screening for hypertensive retinopathy is that retinal vessels are the only blood vessels visible on routine examination. Ophthalmologists and general physicians should work in collaborations to ensure that hypertensive patients are efficiently screened, and timely managed to reduce the risk of ocular and systemic morbidity and mortality. The retinal changes can be halted when hypertension is treated.

hypertension, hypertensive retinopathy, microvasculature

nije evidentirano