EVALUATION OF OPHTHALMOSCOPIC CHANGES OF HYPERTENSION AND ARTERIOLAR SCLEROSIS

Abstract

FOR THE subject of this lecture, I have selected the ophthalmoscopic changes associated with hypertension and arteriolar sclerosis. I shall emphasize certain concepts which are of value in interpreting the ophthalmoscopic signs of these diseases and describe a system of grading these changes which has proved useful to me.¹ Although exhaustive descriptions of these changes are available, the literature on their significance is at times confusing and in many instances contradictory. The three most important reasons for this state of our knowledge are the following: (1) failure to realize that most of the retinal arterial tree is arteriolar in nature, a point emphasized repeatedly by Wagener and associates² and Friedenwald³; (2) failure to utilize knowledge made available by the pathologist and the physiologist of the changes occurring in vessels of similar size elsewhere in the body; (3) inaccurate use of the term "arteriosclerosis." Arteriosclerosis is a general