What are signs of hypertensive retinopathy in a funduscopic evaluation of hypertension (high blood pressure)?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

A study by Wong and Mitchell indicated that independent of other risk factors, the presence of certain signs of hypertensive retinopathy (eg, retinal hemorrhages, microaneurysms, cotton-wool spots) is associated with an increased cardiovascular risk (eg, stroke, stroke mortality). [54]  Consequently, perform a funduscopic eye evaluation to identify any signs of early or late, chronic or acute hypertensive retinopathy, such as arteriovenous nicking or vessel wall changes (eg, copper/silver wiring, hard exudates, flame-shaped hemorrhages, papilledema). Acute or chronic ocular changes can be the initial finding in asymptomatic patients that requires a primary care referral. Alternatively, a symptomatic patient may be referred to the ophthalmologist for visual changes due to hypertensive changes.


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