Retinopati hipertensi

14

Transcript of Retinopati hipertensi

Page 1: Retinopati hipertensi
Page 2: Retinopati hipertensi

Definisi retinopati hipertensiKondisi dimana terdapat berbagai tanda

vaskular retina pada individu yang memiliki peningkatan tekanan darah (NEJM)

Kerusakan retina karena tingginya tekanan darah (PUBMED)

Page 3: Retinopati hipertensi

epidemiologi> 40 tahunKulit hitam >kulit putih

Page 4: Retinopati hipertensi

Vasoconstrictive stage

Arteriovenous nicking /nipping

Copper wiring

TD tinggi yang kronis

Penebalan tunika intima

Degenerasi hialin

Penyempitan fokal arteriol

retina

Page 5: Retinopati hipertensi

exudative stage,

Eksudasi darah dan lipid

Iskemia retinaNekrosis otot

polos dan endotel

Disrupsi pembuluh darah-

retina barrier

Mikro aneurismaPerdarahan

Hard exudateBercak cotton

woolSwelling of optic disc

Page 6: Retinopati hipertensi

DIAGNOSISANAMNESIS

Riwayat hipertensiAsimtomatik hingga buram sekali

PEMERIKSAAN FISIKTD meningkatFunduskopitergantung stage

Page 7: Retinopati hipertensi

Keith Wagener Barker (KWB) GradesGrade 1

Generalised arteriolar constriction - seen as `silver wiring` and vascular tortuosities.

Grade 2As grade 1 + irregularly located, tight constrictions -

Known as `(AV) nicking` or `AV nipping`Grade 3

As grade 2 + with cotton wool spots and flame-hemorrhages

Grade 4As above but with swelling of the optic disk

(papilledema)

Page 8: Retinopati hipertensi

Figure 1. Examples of Mild Hypertensive Retinopathy.

A.arteriovenous nicking (black arrow) and focal narrowing (white arrow).

B. arteriovenous nicking (black arrows) and widening or accentuation (“copper wiring”) of the central light reflex of the arterioles (white arrows).

Page 9: Retinopati hipertensi

Figure 2. Examples of Moderate Hypertensive Retinopathy.

A. shows retinal hemorrhages (black arrows) and a cotton-wool spot (white arrow).

B. shows cotton-wool spots (white arrows) and arteriovenous nicking (black arrows).

Page 10: Retinopati hipertensi

Figure 3. Example of Malignant Hypertensive Retinopathy

Multiple cotton-wool spots (white arrows), retinal hemorrhages (black arrows), and swelling of the optic disk are visible.

Page 11: Retinopati hipertensi

tatalaksanaKontrol tekanan darah

Page 12: Retinopati hipertensi

Classification of Hypertensive Retinopathy on the Basis of Recent Population-Based Data.

Page 13: Retinopati hipertensi

Evaluation and Management of Hypertensive Retinopathy.

Page 14: Retinopati hipertensi

http://eyewiki.aao.org/Hypertensive_retinopathy

http://emedicine.medscape.com/article/1201779-overview

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001994/