classification of hypertensive retinopathy
Last reviewed 01/2018
Modern practice classifies changes into two groups:
- compensated hypertensive retinopathy - groups 1 and 2 in older sources:
- arteriolar changes - mild, generalised attenuation; increased tortuosity; increased opacity with resultant heightened light reflex - "copper" or "silver" wiring
- plus constriction of veins at the arteriovenous crossings - "AV nipping"
- accelerated hypertensive retinopathy - groups 3 and 4 in older sources:
- cotton wool spots (retinal infarcts due to pre - capillary closure), flame haemorrhages, and hard exudates - may surround the macula forming a partial or complete "star"
- papilloedema and often, retinal oedema at the posterior pole of the eye. Visual impairment accompanies macula involvement.