Hypertensive eye disease

Introduction to Hypertensive Eye Disease About 70% of patients with hypertensive eye disease have fundus changes. The fundus positive rate has nothing to do with gender, but it is closely related to the patient's age. The older the positive rate, the higher the positive rate. Among the clinically common hypertensive patients with hypertensive disease, the positive rate of fundus is proportional to the length of the disease course; the longer the course of disease, the higher the fundus positive rate. The classification of hypertensive eye diseases clinically divides hypertensive fundus changes into 4 grades, of which grades 1 and 2 refer to benign hypertension and grades 3 and 4 refer to malignant hypertension. Grade I: slight contraction of the retinal artery and some distortion. The patient has lower blood pressure. Grade II: The retinal artery has a positive local stenosis with an arteriovenous cross. The patient's blood pressure is higher than before, generally no symptoms, heart and kidney function is still good. Grade III: The retinal artery is locally contracted, with bleeding, exudation, and cotton plaque, ie, hypertensive retinopathy. Most patients have significant arteriosclerosis at the same time; blood pressure continues to be high, with heart and kidney damage. Grade IV: The above retinopathy is more serious, and there is papilledema, that is, hypertensive retinopathy. Some patients have more serious damage to the heart, brain and kidney. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: fundus hemorrhage Primary acute angle-closure glaucoma Headache Myopia Conjunctivitis

Causes of hypertensive eye disease

High blood pressure (45%):

Essential hypertensive retinopathy is caused by high blood pressure. Retinal artery contraction and even retinal, papillary lesions are the main manifestations. The extent of fundus lesions is closely related to the length of hypertension and its severity. With the blood pressure drop and control, the fundus hemorrhage, exudation and other diseases are gradually improved, the general effect is very good, but the effect is poor in the late stage.

Hypertensive eye disease prevention

To prevent hypertensive retinopathy, you must strictly control your blood pressure levels, which can be achieved by changing your eating habits, increasing your exercise, and taking antihypertensive drugs. In addition, you must follow up on time.

Hypertensive eye disease complications Complications, fundus hemorrhage, primary acute angle-closure glaucoma, headache, myopia, conjunctivitis

Hypertensive eye disease is a common disease caused by high blood pressure. If you do not pay attention, it will cause the following complications.

First, fundus bleeding: This situation often occurs in patients with hypertension, atherosclerosis, diabetes. Yu Yi occurred in patients with pre-existing hypertension. It can also be secondary to diseases such as retinal vein occlusion and retinal vein inflammation. The main manifestation is a decrease in vision, a black shadow in front of the eyes, and a sudden loss of vision.

Second, acute angle-closure glaucoma: This type of eye disease, more common in older women, patients may have severe headache, eye pain, nausea, vomiting, sudden drop in vision, see the lights appear "rainbow." Some can also have symptoms such as fever and cold. It is easy to be mistaken for a gastrointestinal disease or a cold.

Third, visual decline: the consequences are myopia, dry eye, conjunctivitis, the incidence of greatly increased, dry eyes, redness, burning sensation or foreign body sensation, heavy eyelids, eye pain, headache, decreased vision and other symptoms.

Symptoms of hypertensive eye disease Common symptoms Retinal hemorrhage Retinal vein variability anger eyelids found in the fundus... Papillary edema retinal edema nasal discharge

Hypertensive eye disease is mainly characterized by retinal artery contraction and even retinal and papillary lesions. On the site of about 4 to 6 nipple diameter around the optic papilla, gray edema of the retina, enhanced central reflex of the small artery, arteriovenous cross-sign, bright red flaming bleeding, cotton-like leukoplakia, yellow-white shiny hard exudation and macula Star map.

Examination of hypertensive eye disease

(1) Fundus examination:

1 Retinal artery sputum: seen in the early stage of hypertension, retinal artery general or localized stenosis, arteriovenous ratio disorder; from normal 2:3 to 1:2 or 1:3, arterial straightening, branch angle Sharp; varicose veins after arteriovenous crossing, especially small blood vessels around the macula can be typically spirally curved.

2 retinal arteriosclerosis, mainly showing arterial thinning, reflective enhancement and cross-pressure near sign. The width of normal arterial reflection is about 1/4 to 1/3 of that of the arterial tube. When the arteriosclerosis occurs, due to thickening of the blood vessel wall and denaturation of the vitreous, it is reflected in the wall of the tube, so the reflection is enhanced and widened, and the appearance is copper wire. When it is further hardened, since the density of the tube wall is increased, almost no reflection of the blood column is observed, and a silver filament shape is formed. At the intersection of the arteries and veins, the blood column is not visible due to hardening, and a silver filament is formed. At the intersection of the arteries and veins, due to factors such as compression and pushing of the venous arteries to the veins, the compression signs of different severity can be seen. It appears as a venous occlusion at the intersection, or the veins at the ends of the intersection disappear, or the veins of the cross are skewed, or the veins are depressed, or the veins are arched.

3 retinopathy:

a, hemorrhage, superficial hemorrhage is linear, flaming or flaky, deep hemorrhage is mostly round or round.

b, exudate.

c. Soft exudate, a cotton-like exudate of varying size on the surface of the retina.

d, hard exudate, located in the deep layer of the retina, yellow-white small dots, clear edges.

e. The stellate map of the macula is composed of most simple or fused bright yellow spots.

f, retinal neuropathy: this period is retinopathy plus papilledema, venous engorgement, arteries significantly thin.

(2) Fundus fluorescein angiography. In the early stage of hypertensive retinopathy, retinal artery and capillary stenosis can be seen. When the capillary blood flow is raised to a serious degree, the retina has a cotton-like leukoplakia. Around the capillary ischemic area, dilated tortuous capillaries and microangioma can be seen. Capillary leakage and hard exudation, papilledema and telangiectasia around the optic papilla, fluorescence leakage, and microangioma. Choroidal vascular visualization is irregular, vascular filling is delayed, and there are many drusen of varying sizes. The best way to treat these eye lesions caused by high blood pressure is to control your blood pressure well.

Diagnosis and diagnosis of hypertensive eye disease

The relationship between vasoactive substances and hypertensive eye diseases With the development of techniques such as molecular biology, cell biology, biochemical separation and micro-measurement, research on vasoactive peptides and proto-oncogenes has received increasing attention in the field of ophthalmology, especially They are closely related to the occurrence of hypertension, which is presumed to be one of the important causes of hypertension. A professional ophthalmologist can diagnose hypertensive retinopathy. Ophthalmologists usually use an ophthalmoscope to check the posterior pole of the eye. Characteristics of retinal degeneration include: narrowing of blood vessels, oozing out of the blood vessels, exudation of the retina, called "cotton plaques", edema of the macula and optic disc, and bleeding in the posterior part of the eye.

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