Ophthalmology · UKMLA & AKT
Hypertensive retinopathy
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise hypertensive retinopathy — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Chronic hypertensive retinopathy (BP >140/90 mmHg sustained) - usually asymptomatic, detected incidentally; bilateral and symmetric findings
- Accelerated (malignant) hypertension (BP >180/120 mmHg) - headache, decreased vision, disc swelling
- Fundoscopic signs (chronic, progressive): copper wiring → silver wiring → AV nipping → flame haemorrhages → hard exudates
- Fundoscopic signs (accelerated): cotton wool spots, flame haemorrhages, macular star, disc swelling (papilloedema)
Bilateral symmetric findings distinguish hypertensive retinopathy from retinal vein occlusion (unilateral). AV nipping and copper/silver wiring are the defining features of hypertensive retinopathy - absence should make you favour diabetic retinopathy. Neovascularisation rules IN proliferative diabetic retinopathy and rules OUT hypertensive retinopathy.
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