Hanyang Med Rev.  2016 Aug;36(3):146-150. 10.7599/hmr.2016.36.3.146.

Window to Heart; Ocular Manifestations of Hypertension

• Ma DJ
• Yu HG

• KMID: 2350363
• DOI: http://doi.org/10.7599/hmr.2016.36.3.146

Abstract

Systemic hypertension affects not only the heart, kidneys, brain, and large arteries but also the eyes. High blood pressure (BP) causes a series of pathophysiological changes in the retinal vasculature, including focal and diffuse narrowing of the retinal arteriole, opacification of the arteriolar wall, and compression of the venules by arterioles. In severe cases, hemorrhage, nerve fiber layer infraction, and disc swelling can occur. Systemic hypertension results in various retinal vascular diseases, such as hypertensive retinopathy, retinal vein or artery occlusion, retinal arterial macroaneurysm, and nonarteritic ischemic optic neuropathy. High BP also increases the risk of development and progression of diabetic retinopathy. Signs of hypertensive retinopathy are predictive of target-organ damages, including cardiovascular and cerebrovascular diseases. While managing patients with hypertensive retinopathy, physicians should be aware of the management of cardiovascular and cerebrovascular risk factors.

Keyword

Hypertension; Retinopathy; Cardiovascular Disease; Retinal Vascular Conditions

MeSH Terms

Arteries
Arterioles
Brain
Cardiovascular Diseases
Cerebrovascular Disorders
Diabetic Retinopathy
Heart*
Hemorrhage
Humans
Hypertension*
Hypertensive Retinopathy
Kidney
Nerve Fibers
Optic Neuropathy, Ischemic
Retinal Vein
Retinaldehyde
Risk Factors
Vascular Diseases
Venules
Retinaldehyde

Figure

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  Fig. 1 Hypertensive retinopathy. A cotton wool spot (white arrow) and a compressed venule by an arteriole (black arrow).

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  Fig. 2 Central retinal vein occlusion.

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  Fig. 3 (A) A retinal–arteriolar embolus seen inferior to the optic disc (white arrow), (B) Branch retinal artery occlusion peripheral to the retinal–arteriolar embolus.

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