Rayos , K.- Rodas , F. Case 3. Case 3. 21 year old student CC: Loss of vision OS and eye aches associated with movement. PMH: Similar episode in the OD three years ago with spontaneous resolution. Also, a history of right sided numbness made better with ‘ hilot ’.
(Normal IOP: 15.5 mmHg with fluctuations of 2.75)
- Flame-shaped (splinter hemorrhages)- seen in the nerve fiber layer
- Cotton wool spots – result of microinfarction of NFL which produces aggregates of Cytoid bodies
- Hard waxy exudates may be seen (lipophilic exudates located in Outer plexiform Inner Nuclear layer)
Other retinopathies that are known complications of high blood pressure are called:
1. Cholesterol emboli
2. Calcific emboli
3. Platelet fibrin emboli
Source: Table 241-1. Harrison’s Principles of Internal Medicine 17thed.
Mild Hypertensive Retinopathy – Opthalmoscopy
Figure 1. Examples of Mild Hypertensive Retinopathy.
Panel A shows arteriovenous nicking (black arrow) and focal narrowing (white arrow).
Panel B shows arteriovenous nicking (black arrows) and widening or accentuation ("copper wiring") of the central light reflex of the arterioles (white arrows).
Panel A shows retinal hemorrhages (black arrows) and a cotton-wool spot (white arrow).
Panel B shows cotton-wool spots (white arrows) and arteriovenous nicking (black arrows).
Multiple cotton-wool spots (white arrows), retinal hemorrhages (black arrows), and swelling of the optic disk are visible
Causes of hypofluorescence:
blocking defect (i.e. blood) filling defect (capillary blockage)
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