THE RETINA IN HYPERTENSIVE DISEASE

Abstract

Years of study (27) of the retinal lesions in hypertensive disease with particular reference to the changes in the arterioles and the significance of these changes in the hypertensive patient are reviewed. This work started with the demonstration that edema of the disc in hypertension was consistently associated with elevated spinal fluid pressure. Various degrees of a-v nicking are important to recognize because the significance of minimal and fully developed lesions are different. The fully developed lesion is seen only in hypertensive disease and in 95% of the cases is associated with cardiomegaly. The minimal lesions are seen in non-hypertensive cases as well as in hypertensive disease. A ten-year study of cases of early a-v nicking clearly demonstrated that the lesion took a long time to develop. Recognition and significance of arteriolar narrowing, segmental constriction, and arteriolar thromboses are demonstrated. Their relation to high diastolic types of hypertension is emphasized. While segmental constrictions are a manifestation of the high diastolic types of hypertension, a-v nicking is generally a manifestation of a more chronic type of hypertension of moderate severity.