Fundus and hypertension.
Nature of the changes fundus allows you to visually provide diagnostic and prognostic evaluation at different stages of development of hypertension. Note that the distribution of patients according to degree of change in the fundus is probably more reasonable than the height of arterial pressure.
However, the most common and can be considered an acceptable classification for which the disease is divided into three stages according to the following changes in the fundus: hypertensive retinopathy, functional changes in retinal vessels; angiosclerosis retina, characterized by sclerotic and dynamic changes of retinopathy; hypertensive retinopathy, in which there are changes not only in the vessels, but also in the retina and optic nerve.
Often the results of ophthalmoscopy can detect initial symptoms of hypertension, while when there is no other an objective or subjective evidence of disease. Already in the early phases of development of hypertension in many cases appears the narrowing of retinal vessels. Usually somewhat later discovered and veins, and sometimes their corkscrew-like tortuosity around the macula (symptom Gvist). Quite characteristic is the compression of the extended retinal vein constricted arterial rigidity.
As the disease appear and other ophthalmic indications. Arterioles are often defined as narrow bright, white stripes (a symptom of silver wire) or somewhat broader yellow stripes (a symptom of copper wire). With further progression of hypertension significantly expressed angiospasm lead to changes in the retina and the most: swelling of her nipples and the optic nerve hemorrhages in the retina, the special formation of white and yellowish spots. Such changes, referred to as hypertensive retinopathy, especially pronounced in rapid malignant forms, but often with slowly developing disease in later stages.
The most pronounced changes in the fundus are usually determined in severe hypertension with high blood pressure and some of its variations, but such parallelism is not observed in all cases. Decrease as a result of effective treatment of blood pressure usually leads to a noticeable improvement fundus and visual functions. This improvement under the influence of intensive therapy in many cases occurs even in the late stage of the process. This requires the timely appointment of the combined treatment of hypotensive drugs.