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HypertensioninEye_ES - Hypertension Chronic hypertension...

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Hypertension Chronic hypertension ( Chapter 66 ) produces characteristic retinal vascular findings that can be used to identify and assess progression of the disease. Arterial narrowing, nicking at arteriovenous crossings, nerve fiber layer infarcts, and intraretinal hemorrhages characterize hypertensive retinopathy. Arteriolar sclerosis heightens the arterial light reflexes. Moderately sclerosed arterioles demonstrate “copper wiring,” whereas severely sclerosed vessels show “silver wiring.” Acute hypertension may produce optic nerve edema ( Fig. 449-18 ) and serous retinal detachments that shift dramatically when the patient changes position. These detachments usually resolve without significant sequelae if blood pressure is brought under control. FIGURE 449-18 Papilledema in a young person. Note disc swelling, hemorrhages, and exudates, with preservation of the physiologic cup. Hypertension may be implicated in retinal vascular occlusions. Branch retinal vein occlusion may cause macular edema and decreased visual acuity or may be asymptomatic. Occlusion typically occurs at an
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