Hypertensive retinopathy: a literature review

Enrika Mačiulaitytė1, Raminta Oleškevičiūtė1, Daiva Emilija Rekienė2

1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania

2Lithuanian University of Health Sciences, Department of Internal Medicine, Kaunas, Lithuania


Introduction: Hypertensive retinopathy is a disease that is described as a disorder of the retinal blood vessels, caused by poorly controlled primary or secondary arterial hypertension. People who are diagnosed with this condition tend to have prolonged hypertension, have relatives with the same diagnosis and are smokers. A third of the population in Lithuania has hypertension, so it is important to be aware of the complications.

Aim: to review diagnostics, treatment, and prognosis of hypertensive retinopathy.

Methodology: the literature used for this review was selected using “Google Scholar” and “Pubmed” databases. Following dates from 2012 to 2022, using keywords “hypertensive retinopathy”, “hypertension”, and “eye diseases”. More than 20 publications on hypertensive retinopathy were analysed.

Results. Fundoscopic exam along with previously diagnosed arterial hypertension remains the most important method for diagnosing hypertensive retinopathy. Clinical findings are not significant for diagnosis, whereas optical coherence tomography has the potential to detect and diagnose the disease. The aim of treating hypertensive retinopathy is to lower blood pressure to achieve blood pressure values below 120 – 130/80. Angiotensin – converting enzyme (ACE) inhibitors are the first – line medications for treating this disease.

Conclusions. Hypertensive retinopathy is usually diagnosed during fundoscopic examination when the patient has already been diagnosed with hypertension. Mitchell–Wong classification is used to evaluate the severity of the disease. The main method of management of hypertensive retinopathy is achieving targeted blood pressure with medications. In most cases the prognosis of hypertensive retinopathy is good if blood pressure is well controlled.

Keywords: hypertensive retinopathy, hypertension, eye diseases.

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