1 HTNive Oculopathy I coined the term oculopathy

1 HTNive Oculopathy I coined the term oculopathy because, for reasons that will soon be apparent, a term broader in scope than ‘HTNive retinopathy’ was needed, Stay tuned.

2 Q HTNive Oculopathy 1) Hypertensive retinopathy category of ‘oculopathy’ l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy category of ‘oculopathy’ l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy category of ‘oculopathy’ l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

3 A HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

4 Q HTNive Oculopathy 1) Hypertensive retinopathy l words Most common sign in chronic HTN: arteriolartwoconstriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

5 A HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

6 Q HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l common cause of acute HTN in young female Preeclampsia/eclampsia rare cause of acute HTN in young person Pheochromocytoma not rare cause of acute HTN in young person Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

7 A HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

8 Q HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l eponymous name of lesions Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

9 A HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

10 Q HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = eponymous name of lesions Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

11 A HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

12 Q HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l Presentation depends upon degree and chronicity of HTN

13 A HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l Presentation depends upon degree and chronicity of HTN

14 Q HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN (two words) Severe HTN flame sign hemorrhages at disc margin + disc edema

15 A HTNive Oculopathy 1) Hypertensive retinopathy l Most common sign in chronic HTN: arteriolar constriction 2) Hypertensive choroidopathy l Occurs typically in young patients with acute HTN: l l Preeclampsia/eclampsia Pheochromocytoma Renal disease Signs: l l Hyperpigmented spots with hypopigmented rim = Elschnig spots Linear areas of hyperpigmentation overlying choroidal arteries = Siegrist streaks 3) Hypertensive optic neuropathy l l Presentation depends upon degree and chronicity of HTN Severe HTN flame hemorrhages at disc margin + disc edema

16 HTNive Oculopathy Next we will look at the same topic but from a different perspective….

17 Q HTNive Oculopathy A nonanatomic way to think about HTN and the eye ? ?

18 A HTNive Oculopathy A nonanatomic way to think about HTN and the eye Chronic Acute

19 Q HTNive Oculopathy Chronic What process mediates damage caused by chronic HTN? ? Acute

20 A HTNive Oculopathy Chronic What process mediates damage caused by chronic HTN? Arteriosclerosis Acute

21 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Arteriosclerosis Briefly, what is the pathophysiology of arteriosclerosis? Chronic HTN leads to endothelial-cell damage in the retinal arteriole bed. Endothelial damage allows plasma to leach into the vessel wall, where it clots. Clotting within the wall leads to ‘stiffening’ of the vessel, as well as to narrowing of its lumen.

22 Q/A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Arteriosclerosis Briefly, what is the pathophysiology of arteriosclerosis? cell-type Chronic HTN leads to endothelial-cell damage in the retinal arteriole bed. Endothelial damage allows plasma to leach into the vessel wall, where it clots. Clotting within the wall leads to ‘stiffening’ of the vessel, as well as to narrowing of its lumen.

23 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Arteriosclerosis Briefly, what is the pathophysiology of arteriosclerosis? Chronic HTN leads to endothelial-cell damage in the retinal arteriole bed. Endothelial damage allows plasma to leach into the vessel wall, where it clots. Clotting within the wall leads to ‘stiffening’ of the vessel, as well as to narrowing of its lumen.

24 HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Arteriosclerosis Briefly, what is the pathophysiology of arteriosclerosis? Chronic HTN leads to endothelial-cell damage in the retinal arteriole bed. Endothelial damage allows plasma to leach into the vessel wall, where it clots. Clotting within the wall leads to ‘stiffening’ of the vessel, as well as to narrowing of its lumen.

25 Q HTNive Oculopathy Chronic What process mediates damage caused by chronic HTN? Arteriosclerosis What pathology typically results? ? Acute

26 A HTNive Oculopathy Chronic What process mediates damage caused by chronic HTN? Arteriosclerosis What pathology typically results? Retinopathy Acute

27 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Briefly, what is the pathophysiology of arteriosclerosis? Arteriosclerosis Chronic HTN leads to endothelial-cell damage in the retinal arteriole bed. Endothelial damage allows plasma to leach into the vessel wall, where it clots. Clotting within the wall leads to What pathology typically results? ‘stiffening’ of the vessel, as well as to narrowing of its lumen. Retinopathy How does arteriosclerosis lead to retinopathy? ‘Stiff’ vessels are prone to breaking/leaking, and… compromised vessel lumens lead to nonperfusion in the tissue bed

28 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Briefly, what is the pathophysiology of arteriosclerosis? Arteriosclerosis Chronic HTN leads to endothelial-cell damage in the retinal arteriole bed. Endothelial damage allows plasma to leach into the vessel wall, where it clots. Clotting within the wall leads to What pathology typically results? ‘stiffening’ of the vessel, as well as to narrowing of its lumen. Retinopathy How does arteriosclerosis lead to retinopathy? ‘Stiff’ vessels are prone to breaking/leaking, and… compromised vessel lumens lead to nonperfusion in the tissue bed

29 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Briefly, what is the pathophysiology of arteriosclerosis? Arteriosclerosis Chronic HTN leads to endothelial-cell damage in the retinal arteriole bed. Endothelial damage allows plasma to leach into the vessel wall, where it clots. Clotting within the wall leads to What pathology typically results? ‘stiffening’ of the vessel, as well as to narrowing of its lumen. Retinopathy How does arteriosclerosis lead to retinopathy? ‘Stiff’ vessels are prone to breaking/leaking, and… narrowed vessel lumens lead to nonperfusion in the tissue bed

30 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Arteriosclerosis What pathology typically results? Retinopathy ? ? What are the common manifestations of HTNive retinopathy? ? ?

31 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? Arteriosclerosis What pathology typically results? Retinopathy Arteriolar narrowing What are the Retinal common hemorrhages manifestations of HTNive retinopathy? Microaneurysms A-V nicking Cottonwool spots Neovascularization

32 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis ? What pathology typically results? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms A-V nicking Cottonwool spots Neovascularization

33 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms A-V nicking Cottonwool spots Neovascularization

34 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy ? ? A-V nicking Cottonwool spots Neovascularization

35 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy A-V nicking Cottonwool spots Neovascularization

36 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? A-V Vasospasm leads to lobular nonperfusion of the choriocapillaris. nicking Acutely, these nonperfused spots are hypopigmented; but with time they become hyperpigmented. Cottonwool spots Neovascularization

37 Q/A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? nonperfusion of the choriocapillaris. words A-V Vasospasm leads to lobulartwo nicking Acutely, these nonperfused spots are hypopigmented; but with time they become hyperpigmented. Cottonwool spots Neovascularization

38 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? A-V Vasospasm leads to lobular nonperfusion of the choriocapillaris. nicking Acutely, these nonperfused spots are hypopigmented; but with time they become hyperpigmented. Cottonwool spots Neovascularization

39 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? A-V Vasospasm leads to lobular nonperfusion of the choriocapillaris. nicking Acutely, these nonperfused lobulations (spots) are hypopigmented; but with time they become hyperpigmented. Cottonwool spots Neovascularization

40 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? A-V Vasospasm leads to lobular nonperfusion of the choriocapillaris. nicking Acutely, these nonperfused lobulations (spots) are hypopigmented; but with time they become hyperpigmented. Cottonwool spots. What is the eponymous name of these hyperpigmented spots? Elschnig spots Neovascularization

41 Q/A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? A-V Vasospasm leads to lobular nonperfusion of the choriocapillaris. nicking Acutely, these nonperfused lobulations (spots) are hypopigmented; but with time they become hyperpigmented. Cottonwool spots. What is the eponymous name of these hyperpigmented spots? Elschnig spots Neovascularization

42 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? A-V Vasospasm leads to lobular nonperfusion of the choriocapillaris. nicking Acutely, these nonperfused lobulations (spots) are hypopigmented; but with time they become hyperpigmented. Cottonwool spots. What is the eponymous name of these hyperpigmented spots? Elschnig spots Neovascularization

43 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? HTNive choroidopathy is associated with another Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. hyperpigmented lesion, but. A-V one with a linear rather narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; than lobular shape. What is its. Acutely, eponymous but. Siegrist with timestreaks they become hyperpigmented. Retinal Cottonhemorrhages wool spots. What is the eponymous name of these hyperpigmented spots? Elschnig spots Microaneurysms Neovascularization

44 Q/A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? HTNive choroidopathy is associated with another Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. hyperpigmented lesion, but. A-V one with a linear rather narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; than lobular shape. What is its. Acutely, eponymous but. Siegrist with timestreaks they become hyperpigmented. Retinal Cottonhemorrhages wool spots. What is the eponymous name of these hyperpigmented spots? Elschnig spots Microaneurysms Neovascularization

45 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy Briefly, what is the pathophysiology of HTNive choroidopathy? HTNive choroidopathy is associated with another Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. hyperpigmented lesion, but. A-V one with a linear rather narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; than lobular shape. What is its. Acutely, eponymous but. Siegrist with timestreaks they become hyperpigmented. Retinal Cottonhemorrhages wool spots. What is the eponymous name of these hyperpigmented spots? Elschnig spots Microaneurysms Neovascularization

46 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy HTNive choroidopathy is classically with four Briefly, what is theassociated pathophysiology of conditions— HTNive choroidopathy? HTNive choroidopathy is associated with another what lesion, are they? Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. hyperpigmented but. A-V one with a linear rather narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; than lobular--shape. What is its. Acutely, eponymous -but. Siegrist with timestreaks they become hyperpigmented. -Retinal Cottonhemorrhages wool spots. What is the eponymous name of these hyperpigmented spots? -Elschnig spots Microaneurysms Neovascularization

47 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy HTNive choroidopathy is classically with four Briefly, what is theassociated pathophysiology of conditions— HTNive choroidopathy? HTNive choroidopathy is associated with another what lesion, are they? Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. hyperpigmented but. A-V one with a linear rather narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; than lobular--Pre-eclampsia shape. What is its. Acutely, eponymous --Eclampsia but. Siegrist with timestreaks they become hyperpigmented. --Pheochromocytoma Retinal Cottonhemorrhages wool spots. What is the eponymous name of these hyperpigmented spots? --Acute renal failure Elschnig spots Microaneurysms Neovascularization

48 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy HTNive choroidopathy is classically associated with four Briefly, what is the pathophysiology of conditions— HTNive choroidopathy? All four are associated with another, as-yet-unmentioned HTNive choroidopathy is associated with another what lesion, are they? Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. of severe HTNive choroidopathy. What is it? hyperpigmented but. A-V one with amanifestation linear rather --Pre-eclampsia narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; Exudative retinal detachment (ERD) than lobular shape. What is its. Acutely, eponymous --Eclampsia but. Siegrist with timestreaks they become hyperpigmented. --Pheochromocytoma Retinal Cotton. What are the two most common causes of ERD? (HTNive hemorrhages wool spots --Acute renal failure What choroidopathy ain’t one of of them. ) is the eponymous name these hyperpigmented spots? Neoplasia (often metastatic), and inflammatory processes Elschnig spots Microaneurysms Neovascularization

49 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy HTNive choroidopathy is classically associated with four Briefly, what is the pathophysiology of conditions— HTNive choroidopathy? All four are associated with another, as-yet-unmentioned HTNive choroidopathy is associated with another what lesion, are they? Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. of severe HTNive choroidopathy. What is it? hyperpigmented but. A-V one with amanifestation linear rather --Pre-eclampsia narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; Exudative retinal detachment (ERD) than lobular shape. What is its. Acutely, eponymous --Eclampsia but. Siegrist with timestreaks they become hyperpigmented. --Pheochromocytoma Retinal Cotton. What are the two most common causes of ERD? (HTNive hemorrhages wool spots --Acute renal failure What choroidopathy ain’t one of of them. ) is the eponymous name these hyperpigmented spots? Neoplasia (often metastatic), and inflammatory processes Elschnig spots Microaneurysms Neovascularization

50 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy HTNive choroidopathy is classically associated with four Briefly, what is the pathophysiology of conditions— HTNive choroidopathy? All four are associated with another, as-yet-unmentioned HTNive choroidopathy is associated with another what lesion, are they? Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. of severe HTNive choroidopathy. What is it? hyperpigmented but. A-V one with amanifestation linear rather --Pre-eclampsia narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; Exudative retinal detachment (ERD) than lobular shape. What is its. Acutely, eponymous --Eclampsia but. Siegrist with timestreaks they become hyperpigmented. --Pheochromocytoma Retinal Cotton. What are the two most common causes of ERD? (HTNive hemorrhages wool spots --Acute renal failure What choroidopathy ain’t one of of them. ) is the eponymous name these hyperpigmented spots? Neoplasia (often metastatic), and inflammatory processes Elschnig spots Microaneurysms Neovascularization

51 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy HTNive choroidopathy is classically associated with four Briefly, what is the pathophysiology of conditions— HTNive choroidopathy? All four are associated with another, as-yet-unmentioned HTNive choroidopathy is associated with another what lesion, are they? Arteriolar Vasospasm leads to lobular nonperfusion of the choriocapillaris. of severe HTNive choroidopathy. What is it? hyperpigmented but. A-V one with amanifestation linear rather --Pre-eclampsia narrowing nicking thesename? nonperfused lobulations (spots) are hypopigmented; Exudative retinal detachment (ERD) than lobular shape. What is its. Acutely, eponymous --Eclampsia but. Siegrist with timestreaks they become hyperpigmented. --Pheochromocytoma Retinal Cotton. What are the two most common causes of ERD? (HTNive hemorrhages wool spots --Acute renal failure What choroidopathy ain’t one of of them. ) is the eponymous name these hyperpigmented spots? Neoplasia (often metastatic), and inflammatory processes Elschnig spots Microaneurysms Neovascularization

52 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? A-V-nicking --Cotton-wool spots Neovascularization

53 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? A-V--Peripapillary hemorrhages nicking --Blurring of the disc margin --Disc edema Cotton--Macular exudate (possibly in a ‘star’ configuration) wool spots Neovascularization

54 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? Arteriolar A-V--Peripapillary hemorrhages ‘Disc edema with a macular star’ is thenicking narrowing --Blurring of the disc margin definition of what condition? --Disc edema Neuroretinitis Retinal Cotton--Macular exudate (possibly in a ‘star’ configuration) hemorrhages wool spots What is the #1 cause of neuroretinitis? Cat-scratch disease (CSD) Neovascularization Microaneurysms

55 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? Arteriolar A-V--Peripapillary hemorrhages ‘Disc edema with a macular star’ is thenicking narrowing --Blurring of the disc margin definition of what condition? --Disc edema Neuroretinitis Retinal Cotton--Macular exudate (possibly in a ‘star’ configuration) hemorrhages wool spots What is the #1 cause of neuroretinitis? Cat-scratch disease (CSD) Neovascularization Microaneurysms

56 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? Arteriolar A-V--Peripapillary hemorrhages ‘Disc edema with a macular star’ is thenicking narrowing --Blurring of the disc margin definition of what condition? --Disc edema Neuroretinitis Retinal Cotton--Macular exudate (possibly in a ‘star’ configuration) hemorrhages wool spots What is the #1 cause of neuroretinitis? Cat-scratch disease (CSD) Neovascularization Microaneurysms

57 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? Arteriolar A-V--Peripapillary hemorrhages ‘Disc edema with a macular star’ is thenicking narrowing --Blurring of the disc margin definition of what condition? --Disc edema Neuroretinitis Retinal Cotton--Macular exudate (possibly in a ‘star’ configuration) hemorrhages wool spots What is the #1 cause of neuroretinitis? Cat-scratch disease (CSD) Neovascularization Microaneurysms

58 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? Arteriolar A-V--Peripapillary hemorrhages ‘Disc edema with a macular star’ is thenicking narrowing --Blurring of the disc margin definition of what condition? --Disc edema Neuroretinitis Retinal Cotton--Macular exudate (possibly in a ‘star’ configuration) hemorrhages wool spots What is the #1 cause of neuroretinitis? What is the causative organism in CSD? Cat-scratch disease (CSD) Bartonella henselae Neovascularization Microaneurysms

59 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Choroidopathy & Optic Neuropathy What are the ophthalmoscopic findings in HTNive optic neuropathy? Arteriolar A-V--Peripapillary hemorrhages ‘Disc edema with a macular star’ is thenicking narrowing --Blurring of the disc margin definition of what condition? --Disc edema Neuroretinitis Retinal Cotton--Macular exudate (possibly in a ‘star’ configuration) hemorrhages wool spots What is the #1 cause of neuroretinitis? What is the causative organism in CSD? Cat-scratch disease (CSD) Bartonella henselae Neovascularization Microaneurysms

60 Q HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy A-V nicking Cottonwool spots Neovascularization HTN is a risk factor for several retinal vascular events that convey significant ocular morbidity— what are they? ----

61 A HTNive Oculopathy Chronic Acute What process mediates damage caused by chronic HTN? What process mediates damage caused by acute HTN? Arteriosclerosis Vasospasm What pathology typically results? What pathologies (2) typically result? Retinopathy Arteriolar narrowing Retinal hemorrhages Microaneurysms Choroidopathy & Optic Neuropathy A-V nicking Cottonwool spots Neovascularization HTN is a risk factor for several retinal vascular events that convey significant ocular morbidity— what are they? --Retinal arterial occlusions (branch and central) --Retinal venous occlusions (ditto) --Retinal macroaneurysms