Moderate hypertensive retinopathy
| Sign | Diagnosis | Histopathology correlations | Clinical correlations | Future research | ||||
|---|---|---|---|---|---|---|---|---|
| Microaneurysm | Present v absent | Exudative phase: disruption of blood-barrier, degeneration of vascular smooth muscle and endothelial cell necrosis leading to blood and lipid exudation and ischaemia6 | • Risk of any stroke (relative risk, 6.11; CI 95% 3.72 to 10.05)34 • Risk of cognitive impairment :strong association36 | Prevention • Is retinal photography useful in the measurement of stroke risk? | ||||
| Retinal haemorrhage (blot, dot, or flame,shaped) | • Blot • Flame shaped • Both | • Exudative phase | • Risk of any stroke (relative risk, 6.44; CI 95% 3.61 to 11.49)34 • Risk of any stroke (relative risk, 6.38; CI 95% 2.97 to 13.73)34 • Risk of cognitive impairment:strong association36 | Prevention | ||||
| (a) Is retinal photography useful in the measurement of stroke risk? | ||||||||
| (b) Cognitive impairment may be amenable to treatment and prevented strategies targeted at vascular diseases | ||||||||
| Soft exudates | Present v absent | Ischaemia of the nerve fibre layer | • Risk of any stroke (relative risk 7.80, CI 95% 4.07 to 14.96)34 • Risk of cognitive impairment:strong association36 | Prevention | ||||
| • It is important to replicate some of these findings in other populations to assess the associations of retinal microvascular disease to different stroke subtypes and to other clinical and subclinical cerebral disorders with a supposed microvascular aetiology |