What Causes Arteriovenous Nicking?

This is most commonly seen in eye disease caused by

high blood pressure (hypertensive retinopathy)

.

How common is AV nicking?

Prevalence of AV nicking and focal retinal arteriolar narrowing increased with age and was between

4.2% to 14.3% for AV nicking

and 5.3% to 14.9% for focal retinal arteriolar narrowing. The corresponding 5-year incidence was 6.5% to 9.9%.

What are signs of hypertensive retinopathy?

Hypertensive retinopathy is retinal vascular damage caused by hypertension. Signs usually develop late in the disease. Funduscopic examination shows

arteriolar constriction, arteriovenous nicking, vascular wall changes, flame-shaped hemorrhages, cotton-wool spots, yellow hard exudates, and optic disk edema

.

What diseases cause cotton-wool spots?

Cotton-wool spots (CWSs) are common retinal manifestations of many diseases including

diabetes mellitus, systemic hypertension, and acquired immunodeficiency syndrome

. Clinically they appear as whitish, fluffy patches on the retina and eventually fade with time.

At which stage of hypertensive retinopathy retinal ischemia occurs?

Exudative Phase

In this stage, retinal signs occur such as retinal hemorrhage (flame-shaped and dot blot), hard exudate formation, necrosis of smooth muscle cells and retinal ischemia (cotton-wool spots).

What is the most common cause of malignant hypertension?

• Collagen vascular disease, such as scleroderma.
• Kidney disease.
• Spinal cord injuries.
• Tumor of the adrenal gland.
• Use of certain medications, including birth control pills and MAOIs.
• Use of illegal drugs, such as cocaine.

Is retinopathy a disease?

Retinopathy means

disease of the retina

. There are several types of retinopathy but all involve disease of the small retinal blood vessels. Signs of retinopathy (see photograph) can be seen when the retina is viewed through the pupil with an ophthalmoscope.

Can you recover from hypertensive retinopathy?

Outcome. The retina will usually

recover if the blood pressure can be controlled

, but a grade 4 level of retinopathy is likely to involve permanent damage to the optic nerve or macula.

What is the treatment of hypertensive retinopathy?

Your doctor may prescribe

blood pressure medications such as diuretics, beta-blockers, or ACE inhibitors

. You can control this condition by controlling your blood pressure. If your condition is severe, however, you may have irreversible eye damage that causes permanent vision problems.

What is normal blood pressure by age?

Are cotton wool spots serious?

Disease entity

In otherwise healthy patients, the observance of a cotton wool spot (CWS) is

not considered normal

. A single cotton wool spot in one eye can be the earliest ophthalmoscopic finding in diabetic or hypertensive retinopathy.

Can cotton wool spots be treated?

Cotton-wool spots are tiny white areas on the retina, the layer of light-sensing cells lining the back of the eye. Caused by a lack of blood flow to the small retinal blood vessels, they

usually disappear without treatment

and do not threaten vision.

What’s the difference between cotton wool spots and exudates?

Cotton-wool spots are often referred to using the misnomer “soft exudates” and are described as slightly elevated, small, yellow-white or gray-white, cloud-like, linear or serpentine lesions with fimbriated borders in the superficial retina (Fig. 51.13).

What does hypertensive retinopathy look like?

The signs include

flame shaped hemorrhages

at the disc margin, blurred disc margins, congested retinal veins, papilledema, and secondary macular exudates. Hard exudates can deposit in the macula causing a macular star. Optic nerve pallor is also present in patients with chronic hypertension.

Can hypertension affect the eyes?

High blood pressure can

damage

the tiny, delicate blood vessels that supply blood to your eyes, causing: Damage to your retina (retinopathy). Damage to the light-sensitive tissue at the back of your eye (retina) can lead to bleeding in the eye, blurred vision and complete loss of vision.

Does high blood pressure cause retinal detachment?

The higher the blood pressure and the longer it has been high, the more severe the damage is likely to be.

High blood pressure can’t directly cause retinal detachment

. But if you have high blood pressure, you are at a higher risks of retinal detachment.