Retinopati hipertensi
Transcript of 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)
epidemiologi> 40 tahunKulit hitam >kulit putih
Vasoconstrictive stage
Arteriovenous nicking /nipping
Copper wiring
TD tinggi yang kronis
Penebalan tunika intima
Degenerasi hialin
Penyempitan fokal arteriol
retina
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
DIAGNOSISANAMNESIS
Riwayat hipertensiAsimtomatik hingga buram sekali
PEMERIKSAAN FISIKTD meningkatFunduskopitergantung stage
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)
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).
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).
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.
tatalaksanaKontrol tekanan darah
Classification of Hypertensive Retinopathy on the Basis of Recent Population-Based Data.
Evaluation and Management of Hypertensive Retinopathy.
http://eyewiki.aao.org/Hypertensive_retinopathy
http://emedicine.medscape.com/article/1201779-overview
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001994/