Hello and welcome to the Zero to Finals podcast.

My name is Tom, and in this episode, I'm going to be going through

Hypertensive Retinopathy.

And if you want to follow along with written notes on this topic, you can follow along

at zero definals.com slash hypertensive retinopathy,

or in the ophthalmology section of the zero to finals medicine book.

So let's get straight into it.

Hypertensive retinopathy describes the damage to the small blood vessels in the retina that relates to

systemic hypertension or high blood pressure.

This can be the result of years of chronic hypertension, or it can develop

quickly in response to malignant hypertension, which is a severely high blood pressure. There are

a number of signs that occur in the retina in response to hypertension in these vessels. And we'll go

through some of those signs. Silver wiring or copper wiring is where

the walls of the arterials become thickened and sclerosed and this causes increased reflection of

light on examination. So it looks like small silver or copper wires in the walls of the arterials.

Arteriovenous nipping is where the arterials cause compression of the veins where the

veins and the arteries cross. And this again is due to sclerosis and hardening of the arterials

which squash down the veins which have softer vessel walls,

meaning they're more pliable.

So they get squashed where the two vessels cross.

Cotton wool spots are caused by ischemia and infarction in the retina,

causing damage to the nerve fibres.

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