Wong and Mitchell reported a grading system for hypertensive retinopathy. The authors are from the University of Melbourne and National University of Singapore.
Patient selection: hypertension
Fundoscopic Finding
Grade
none
none
focal or generalized arteriolar narrowing, arteriovenous nicking, copper wiring of arteriolar wall
mild
hemorrhage, microaneurysm, cotton-wool spot, hard exudate
moderate
moderate retinopathy AND swelling of optic disc
malignant
where:
• Hemorrhages may be dot, blot or flame-shaped.
• The diagnosis of malignant retinopathy requires exclusion of anterior ischemic optic neuropathy.
The presence of hypertensive retinopathy is associated with stroke and coronary heart disease, especially if a person is under 55 years of age.
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