What are the grades of hypertensive retinopathy?

What are the grades of hypertensive retinopathy?

Grade 1: Barely detectable arterial narrowing. Grade 2: Obvious arterial narrowing with focal irregularities (Figure 1) Grade 3: Grade 2 plus retinal hemorrhages, exudates, cotton wool spots, or retinal edema (Figure 3) Grade 4: Grade 3 plus papilledema (Figure 4)

What is arteriolar reflex?

Increased arteriolar light reflex refers to an increased light reflex from the central portion of the retinal arteriolar surface (Figures 1 and ​ 2).

What is silver wiring in hypertensive retinopathy?

Retinal arterioles appear orange or yellow instead of red (“copper wiring” ) Retinal arterioles look white if they have become occluded (“silver wiring” ) Retinal arterioles indent retinal veins as they cross each other (“arteriovenous nicking” )

Is hypertensive retinopathy an emergency?

Hypertensive retinopathy is a common complication of systemic hypertension. Hypertensive choroidopathy is a less-common complication of systemic hypertension but can be the harbinger of a potentially life-threatening hypertensive emergency with end-organ damage.

What is arteriolar attenuation?

Retinal vessel attenuation is recognized as an almost universal finding in eyes with RP, 1 and is mainly thought to reflect decreased metabolic demand of the degenerating retina, 2 where loss of oxygen consumption leads to increased local oxygen levels in the inner retina that in turn results in vasoconstriction.

What is AV ratio?

ratio, AV. The ratio of the diameter of the ret-inal arteries to that of the retinal veins. It is usually around two-thirds. Deviations from this value may indicate a vascular disease (e.g. hypertension).

What is Microaneurysms of the eye?

Microaneurysms are usually the earliest visible manifestation of diabetic retinopathy. They appear as tiny red dots scattered in the retina posteriorly (single arrows). They may be surrounded by a ring of yellow lipid, or hard, exudates (double arrow).

What is focal arteriolar narrowing?

Focal arteriolar narrowing is attributed to localized areas of spasm of the arteriolar wall and can be reversible. Persistent focal arteriolar narrowing may be due to edema in the wall of the arteriole or to localized areas of fibrosis.

What is AV ratio retina?

The ratio of retinal arteriolar to venular diameters is often used as a marker of generalized arteriolar narrowing. There are several ways to determine the retinal arteriovenous ratio (A/V ratio). However, no comparison of retinal vascular measurements and A/V ratios determined by different formulae has been presented.

What are the four grades of hypertensive retinopathy?

The first comprehensive classification of hypertensive retinopathy was provided by Keith, Wagener and Barker five decades later and was defined by four grades of retinal damage: grade 1 (narrowing), grade 2 (arteriovenous crossings), grade 3 (haemorrhages and exudates) and grade 4 (papilloedema).

Are Grade 1 and Grade 2 retinopathy different from Wong–Mitchell classification?

First, at difference from Wong–Mitchell classification, grades 1 and 2 retinopathy defined according to Keith–Wagener–Barker scale was unable to show an independent relation with PWV and CCSA in age and sex-based analysis. In particular, no differences in TOD were observed in participants with grade 2 as compared to those with grade 1 retinopathy.

What is the prognosis of Grade 3 retinopathy?

They showed that the presence of optic disk oedema (grade 4), haemorrhages and/or exudates (grade III) was related to a 5-year survival rate of 1 and 20%, respectively, as opposed to 70 and 50% of patients with grade 1 and 2 retinopathy at the initial evaluation, respectively.

Is there an association between the grade of retinopathy and mortality?

As grade 3 + optic disc edema + macular star “Silver Wiring” There is an association between the grade of retinopathy and mortality. In a classic study in 1939 Keith and colleagues described the prognosis of people with differing severity of retinopathy.