Modern Aspects of Hypertensive Angioretinopathy

Abstract

This literature review is devoted to modern problems of hypertensive retinopathy with arterial hypertension, as well as hypertensive retinopathy in combination diseases. The latest world studies were analyzed. Particular attention is paid to the clinical disease characteristics at the present stage with the analysis of the arterio-venous ratio, optic nerve edema (with high blood pressure figures) using an automated system, vector analysis, suggesting a new arteriovenous classification, called Web Integration (Wivern). The modern pathogenesis of hypertensive retinopathy, namely the ratio of proangiogenic and anti-angiogenic factors, the role of inflammation (C-reactive protein), the role of endothelin-1, endostatin, interleukin-8 (IL-8), and the main fibroblast growth factor (bFGF ), angiogenin and uric acid. The special importance of fundus registration is reflected with the help of the newest equipment at high figures of arterial pressure in patients with hypertensive retinopathy. It is known that according to the World Health Organization (WHO), mortality rate from cardiovascular diseases is 31 %. Hypertension is the main risk factor for coronary heart disease, myocardial infarction, heart failure, stroke, kidney disease and early death. Questions of eye blood flow in hypertensive angioretinopathy in patients with arterial hypertension (AH) are covered. Hypertensive retinopathy (HR) is a retinal disease that is caused by a prolonged increase blood pressure (BP) and leads to a decrease in vision. The data of pathophysiology are analyzed (arterial hypertension (AH) leads to thickening of the vessels of the inner membrane (intima), to thickening of the medial membrane (media) — hyperplasia of the muscular tissue followed by hyaline degeneration with the development of sclerotic changes). The questions of modern diagnostics with retinal morphological status evaluation (OCT), detection of eye fundus condition with newest fundus camers, pathogenetic aspects are discussed. This review will help to prevent the development of more severe forms of hypertensive retinopathy. This information will allow us to identify the most significant indicators in the early diagnosis of hypertension angioretinopathy.

Keywords

• аrterial hypertension
• retinopathy
• ocular blood flow
• cardiovascular risk
• autoregulatory mechanisms