Hypertensive Retinopathy

Hypertensive Retinopathy

It is the retinal vascular damage caused by hypertension. The symptoms typically appear at the advanced stages of the damage. Fundus examination may reveal narrowing of small arteries, pressure on the veins, vascular wall changes, flame-shaped retinal hemorrhages, lipid leakages, white nerve fiber edemas and optic nerve head edemas. The most crucial step in treatment is hypertension control. If retinal edema or vein occlusion develops, laser photocoagulation, intraocular use of anti-VEGF drugs or cortisone injection may be performed.


Acute hypertension causes a temporary narrowing in the retinal blood vessels, whereas long-term high blood pressure causes permanent changes in the vascular wall. Smoking may aggravate the condition, increasing the risk of retinal vein occlusion. Existence of hypertensive retinopathy is an indicator of hypertension-related damage in other organs of the body.


Diagnosis is made by fundus examination. Severe and acute hypertension may lead to loss of vision due to macular degeneration, optic nerve edema and serous retinal detachment.  In chronic hypertension, there will be no symptoms until retinal vein occlusion occurs.  The examination may reveal thinning in the arteries, color change and pressure on the veins. In cases of edema, serous detachment or vein occlusion, supplementary tests such as OCT and FFA are performed.

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