<p>A Review of Hypertensive Retinopathy and Chorioretinopathy</p>

Abstract

Hypertensive retinopathy and choroidopathy have important short-and long-term implications on patients' overall health and mortality. Eye care professionals should be familiar with the severity staging of these entities and be able to readily recognize and refer patients who are in need of systemic blood pressure control. This paper will review the diagnosis, staging, treatment, and long-term implications for vision and mortality of patients with hypertensive retinopathy and choroidopathy.

Influence of ACPA‐positive rheumatoid arthritis on visual field testing in patients with arterial hypertension: A comparative cross‐sectional study

“…Seven out of 26 aHT patients and five out of 20 RA patients, demonstrated degree I hypertensive fundus changes based on the classification of Keith-Wagener. 8 Marginal constrictions and coils of the retinal arteries were noted. After correction with the Bonferroni-Holm method, no significant differences in mean arterial pressure (MAP), systolic and diastolic blood pressure were seen between the groups.…”

“…Indeed, morphological changes of the retina in association with aHT have been identified clinically in funduscopy and described in the classification of hypertensive retinopathy. 8 Nevertheless, the impact of the related microcirculatory hemodynamic disturbances and RA-associated inflammatory changes on retinal sensory cells and their function has not been investigated thoroughly. We assume that a form of functional impairment occurs in retinal sensory cells when blood and oxygen supply are limited in atherosclerotic microvessels.…”

Galectins in the Pathogenesis of Common Retinal Disease

“…Overall, the incidence of HR exceeds 60% among hypertensive patients. HR manifests as mild, moderate and severe retinopathy with symptoms ranging from general arteriolar narrowing and wall opacity leading to retinal haemorrhage, microaneurysm and hard exudates or even optic disc swelling (Erden and Bicakci, 2012;Tsukikawa and Stacey, 2020). Whilst galectins have not been directly implicated in the pathogenesis of HR, it is noteworthy that Gal-1, as a regulator of L-type CaV1.2 channels, may be an important regulator of blood pressure (Hu et al, 2018).…”

“…With increasing prevalence of Abbreviations: AFL, aflibercept; AGE, advanced glycation end product; AMD, Age-related macular degeneration; BRB, bloodretinal barrier; CRD, carbohydrate recognition domain; DMO, diabetic macular oedema; DR, diabetic retinopathy; EAU, experimental autoimmune uveitis; EMT, epithelial to mesenchymal transition; HR, hypertensive retinopathy; IL, interleukin; NPDR, nonproliferative DR; OIR, oxygen-induced retinopathy; PDR, proliferative DR; PKC, protein kinase C; PVR, proliferative vitreoretinopathy; RHO, rod opsin; ROP, retinopathy of prematurity; RP, retinitis pigmentosa; RPE, retinal pigment epithelium; RVO, retinal vein occlusion; VEGF, vascular endothelial growth factor; VEGFR, VEGF receptor. Landau and Kurz-Levin (2011) Vitreous liquifies with age and eventually detaches from the retina Landau and Kurz-Levi (2011) thickening and arterial narrowing; focal or diffuse arterial wall opacification Malignant-optic nerve swelling Harjasouliha et al (2017); Kabedi et al (2014); Tsukikawa and Stacey (2020) -Moderate or sclerotic phase (hemorrhages, microaneurysms, cottonwool spots, exudates) Malignant or exudative phase (moderate retinopathy and optic disk swelling) Age-related macular degeneration (AMD) Dry (non-neovascular)-slow but progressive decrease in visual acuity, increasing light sensitivity, and reading difficulties Dry-yellow lesions (drusen) below the RPE, atrophy or hyperpigmentation of the RPE Gal-1 upregulated in a model of wet AMD Wu et al (2019) Wet (neovascular)-sudden, often quite marked, decrease in visual acuity; can results in permanent reduction of vision as well as a central scotoma Wet-neovascular growth of the choroid; bleeding and exudation from these vessels can damage the outer retina, leading to photoreceptor degeneration Margalit and Srinivas (2003); Landau and Kurz-Levin (2011) Gal-2, -7, -8 upregulated in RPE/ choroid samples of some forms AMD; Gal-8, -12 downregulated in neuroretina of pre-AMD patients, and Gal-3 upregulated in most forms of AMD Newman et al (2012) Gal-3 upregulated in choroid samples from advanced dry AMD Yuan et al (2010) (Continued on following page)…”

Classification of Eye Diseases in Fundus Images

“…• Clinically significant macular edema • Non-central-involved macular edema • Central-involved macular edema Figure 4 shows a healthy retinography and clinically significant macular edema. The vascular changes associated with systemic elevated blood pressure are visible in the retina as Hypertensive Retinopathy (HR) [7]. In Figure 5, the grades of HR can be observed.…”