Hypertensive retinopathy

Retinopathy is an affection of the retina caused by general diseases of the organism (hypertensive disease, diabetes mellitus, symptomatic hypertension, and atherosclerosis). Retinopathy is dangerous due to the fact that it may provoke sharp occlusions of the blood vessels in the retina and the optic nerve which require immediate treatment. In the absence of treatment, retinopathy may result in the loss of vision due to atrophy of the optic nerve or dystrophy of the retina.

The affection complex which occurs in the retina and its blood vessels in case of hypertension (high blood pressure) is called hypertensive retinopathy. This is perhaps one of the most common manifestations of hypertension.
Hypertensive retinopathy deals with hemorrhages and exudation within the eye fundus and also edema of the optic nerve.

The risk groups

• Old-aged people
• People with high arterial blood pressure
• People with the hypertension disease, kidney hypertension, and adrenal disease.

Hypertensive retinopathy often has no symptoms. At advanced stages of the disorder, a reduction of visual acuity occurs.

Stages of hypertensive retinopathy

Specialists identify four stages of hypertensive retinopathy:

• Hypertensive angiopathy – reversible functional changes which affect only the blood vessels of the retina;
• Hypertensive angiosclerosis – organic changes in the retinal blood vessels;
• Hypertensive retinopathy –around the modified blood vessels there appear foci in the retina tissue: focal dimness, hemorrhages and degenerative changes in its central section, sometimes there occur “star” or “semistar” pictures;
• Hypertensive neuroretinopathy — results not only in angiopathy, angiosclerosis, and retinopathy but also in edema and dimness of the retina over the optic nerve head. The more pronounced changes in the retina and optic nerve lead to poor vision and narrowing of the field of vision.

Diagnostics of hypertensive retinopathy

In order to confirm or refuse the diagnosis of hypertensive retinopathy, it is necessary to undergo a comprehensive diagnostic testing of the visual system. The Excimer Eye Clinic performs diagnostics with help of the latest computer-based equipment which provides a full picture of patient’s vision.
Diagnostic testing of patients with retinal detachment includes not only standard procedures but also:

• Ophthalmoscopy – diagnostics of the eye fundus;
• Ultra-sonic examination of the internal structures of the eye – A-scanning and B-scanning;
• Electrophysiological examination;
• Optical coherent tomography of the retina

Treatment for hypertensive retinopathy

Beyond any doubt, a treatment technique for hypertensive retinopathy depends on the grade of the disease. In most cases, therapy begins with medications (vasodilating preparations, anti-coagulants, various vitamins, etc.) Surgery is also used as a treatment method with help of laser photocoagulation and hyperbaric oxygenation.

The treatment for hypertensive retinopathy is symptomatic (mediations and laser photocoagulation). The main factor contributing to improved state of the retina is the normalization of arterial blood pressure. This requires continuous observation.

Delaying treatment is fraught with the danger of the vision loss. It is important to bear in mind that hypertensive retinopathy may lead to a substantial reduction of vision to the extent of complete blindness. In order to avoid these complications, it is necessary to see an ophthalmologist at least once a year. Only a specialist is able to identify the disorder at its early stages and prescribe the necessary treatment.