Change Language German

Classification (Modified Scheie)

• Grade 0: No changes
• Grade 1: Subtle arterial narrowing, beginning crossing signs
• Grade 2: Obvious arterial narrowing, obvious crossing signs, Salus’s sign (deflection of retinal vein as it crosses the arteriole)
• Grade 3: Grade 2 + retinal haemorrhages, exsudates, cotton wool spots, macular edema
• Grade 4: Grade 3+ optic disc edema ¹

Work-up

• measure blood pressure
• cardiovascular risk factors
• consider fluorescence angiography

Management

• treat blood pressure, emergency referral for very high blood pressure/severe hypertensive retinopathy

Sources

• EyeWiki Hypertensive Retinopathy
• Kanski’s Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)
• The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition(2021)
• Modi P, Arsiwalla T. Hypertensive Retinopathy. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525980/
• ¹ von Eyerounds.org, © The University of Iowa; Licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
  • ¹ Contributor: C. Blake Perry, MD, The University of Iowa