Abstract
Systemic (essential) hypertension is common and has well-described effects on the retinal and choroidal vasculature. Because systemic hypertension is frequently asymptomatic, the presenting signs and symptoms may be visual. Hypertensive retinopathy has been linked to increased vascular morbidity and mortality. Therefore, early detection of ophthalmologic changes may lead to intensified blood pressure management, thus preserving vision and improving general health. In addition, hypertension is associated with several important retinal diseases, including retinal vascular occlusion, diabetic retinopathy, and anterior ischemic optic neuropathy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289: 2560–72.
Liebreich R. Ophthalmoskopischer Befund bei Morbus Brightii. Albrecht Von Graefes Arch Ophthalmol. 1859;5:265–8.
Gunn RM. Ophthalmoscopic evidence of (1) arterial changes associated with chronic renal diseases and (2) of increased arterial tension. Trans Ophthalmol Soc UK. 1892;12:124–5.
DellaCroce JT, Vitale AT. Hypertension and the eye. Curr Opin Ophthalmol. 2008;19:493–8.
Wong TY, Mitchell P. The eye in hypertension. Lancet. 2007;369:425–35.
Keith N, Wagener H, Barker N. Some different types of essential hypertension: their course and prognosis. Am J Med Sci. 1939;197:332.
Scheie HG. Evaluation of ophthalmoscopic changes of hypertension and arteriolar sclerosis. AMA Arch Ophthalmol. 1953;49:117–38.
Wong TY, Mitchell P. Hypertensive retinopathy. N Engl J Med. 2004;351:2310–7.
Tso MO, Jampol LM. Pathophysiology of hypertensive retinopathy. Ophthalmology. 1982;89:1132–45.
Hayreh SS. Duke-Elder lecture: systemic arterial blood pressure and the eye. Eye. 1996;10:5–28.
Kishi S, Tso MO, Hayreh SS. Fundus lesions in malignant hypertension. II. A pathologic study of experimental hypertensive optic neuropathy. Arch Ophthalmol. 1985;103:1198–206.
Luo BP, Brown GC. Update on the ocular manifestations of systemic arterial hypertension. Curr Opin Ophthalmol. 2004;15:203–10.
Umapathi T, Wong SL. Unilateral malignant hypertensive retinopathy. Neurology. 2006;67:690.
Suzuki M, Minamoto A, Yamane K, et al. Malignant hypertensive retinopathy studied with optical coherence tomography. Retina. 2005;25:383–4.
Olson JL, Prall FR, Ciardella AP. Bilateral foveal neurosensory detachment in hypertensive retinopathy demonstrated by optical coherence tomography. Eye. 2006;20:1370–1.
Wong TY, Klein R, Couper DJ, et al. Retinal microvascular abnormalities and incident strokes: the Atherosclerosis Risk in Communities Study. Lancet. 2001;358:1134–40.
Wong TY, Klein R, Sharrett AR, et al. Retinal microvascular abnormalities and cognitive impairment in middle-aged persons: the Atherosclerosis Risk in Communities Study. Stroke. 2002;33:1487–92.
Wong TY, Klein R, Nieto FJ, et al. Retinal microvascular abnormalities and 10-year cardiovascular mortality: a population-based case–control study. Ophthalmology. 2003;110:933–40.
Kishi S, Tso MOM, Hayreh SS. Fundus lesions in malignant hypertension: I. A pathologic study of experimental hypertensive choroidopathy. Arch Ophthalmol. 1985;103:1189–97.
Elschnig A. Die diagnostische und prognostische Bedeutung der Netzhauterkrankungen bei Nephritis. Wien Med Wochenschrift. 1904;54:446.
Ugarte M, Horgan S, Rassam S, Leong T, Kon CH. Hypertensive choroidopathy: recognizing clinically significant end-organ damage. Acta Ophthalmol. 2008;86: 227–8.
Yang SS, Fu AD, McDonald RH, et al. Massive spontaneous choroidal hemorrhage. Retina. 2003;23(2): 139–44.
National High Blood Pressure Education Working Group. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 suppl):555–76.
Foster BJ, Ali H, Mamber S, Polomeno RC, Mackie AS. Prevalence and severity of hypertensive retinopathy in children. Clin Pedatr (Phila). 2009;48:926–30.
Dimmitt SB, West JN, Eames SM, et al. Usefulness of ophthalmoscopy in mild to moderate hypertension. Lancet. 1989;1:1103–6.
Tramontan L, Grisan E, Ruggeri A. An improved system for the automatic estimation of the arteriolar-to-venular diameter ratio (AVR) in retinal images. Conf Proc IEEE Eng Med Biol Soc. 2008;2008:3550–3.
Bock KD. Regression of retinal vascular changes by antihypertensive therapy. Hypertension. 1984;6:III-158–62.
Wong TY. Fred Hollows lecture: hypertensive retinopathy: a journey from fundoscopy to digital imaging. Clin Exp Ophthalmol. 2006;34:397–400.
Sabbatini M, Tomassoni D, Di Tullio MA, Amenta F. Neuroprotective effect of treatment with calcium antagonists on hypertensive retina. Clin Exp Hypertens. 2002;24:727–40.
Susic D. Hypertension, aging, and atherosclerosis: the endothelial interface. Med Clin North Am. 1997;81: 1238–40.
Morriss DS, Somner J, Donald MJ, et al. The eye at altitude. Adv Exp Med Biol. 2006;588:249–70.
Raja V, Rajagopalan S, Kashab T, Moriarty B. Radiation retinopathy: a mistaken diagnosis of hypertensive retinopathy. Clin Exp Optom. 2007;90: 468–70.
Sharp PS, Chaturvedi N, Wormald R, McKeigue PM, Marmot MG, Young SM. Hypertensive retinopathy in Afro-Caribbeans and Europeans: prevalence and risk factor relationships. Hypertension. 1995;25:1322–5.
Wong TY, Klein R, Duncan BB, et al. Racial differences in the prevalence of hypertensive retinopathy. Hypertension. 2003;41:1086–91.
Pontremoli R, Sofia A, Tirotta A, et al. The deletion polymorphism of the angiotensin 1-converting enzyme gene is associated with target organ damage in essential hypertension. J Am Soc Nephrol. 1996;7:2550–8.
Yilmaz MI, Sonmez A, Kilic S, et al. The association of plasma adiponectin levels with hypertensive retinopathy. Eur J Endocrinol. 2005;152:233–40.
Hayreh SS, Joos KM, Podhajsky PA, Long CR. Systemic diseases associated with nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1994;118:766–80.
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.
Rabb MF, Gagliano DA, Teske MP. Retinal arterial macroaneurysms. Surv Ophthalmol. 1988;33:73–96.
Wilson LA, Warlow CP, Russell RW. Cardiovascular disease in patients with retinal arterial occlusion. Lancet. 1979;1:292–4.
Mitchell P, Wang JJ, Li W, Leeder SR, Smith W. Prevalence of asymptomatic retinal emboli in an Australian urban community. Stroke. 1997;28:63–6.
Hayreh SS, Zimmerman B, McCarthy MJ, Podhajsky P. Systemic diseases associated with various types of retinal vein occlusion. Am J Ophthalmol. 2001;131:61–77.
Age-Related Eye Disease Study Research Group. Risk factors associated with age-related macular degeneration. A case–control study in the Age-Related Eye Disease Study: Age-Related Eye Disease Study report number 3. Ophthalmology. 2000;107:2224–32.
Mitchell P, Lee AJ, Roctchina E, Wang JJ. Open-angle glaucoma and systemic hypertension: the Blue Mountains Eye Study. J Glaucoma. 2004;13:319–26.
Park YH, Kim SY, Lee YC. Macular hole formation, spontaneous closure, and reopening in severe hypertensive choroidopathy. Clin Experiment Ophthalmol. 2007;35:586–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Schwartz, S.G., Schneider, S., Mieler, W.F. (2013). Retinal and Choroidal Manifestations of Systemic Hypertension. In: Arévalo, J. (eds) Retinal and Choroidal Manifestations of Selected Systemic Diseases. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3646-1_22
Download citation
DOI: https://doi.org/10.1007/978-1-4614-3646-1_22
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-3645-4
Online ISBN: 978-1-4614-3646-1
eBook Packages: MedicineMedicine (R0)