grading of hypertensive retinopathy

KEITH- WAGNER -BARKER CLASSIFICATION 1939-

-based on retinal changes in known grade of HYPERTENSION

GROUP I

-mild HTN

-minimal constriction of retinal arteroles<generalised>

-some tortuosity of retinal arteroles

GROUP II

-minimal or no other systemic involvement

-I +

-more definite focal narrowing

-arteriovenous nicking

GROUP III

-identifiable cardiac , cerebral , or renal dysfunction

-I+ II+

-hemorrhages

-exudates

-vasospastic changes

-cotton wool spot

GROUP IV

-more severe cardiac , cerebral , or renal dysfunction

-optic disc edema (v/s papilloedema from raised ICT - presence of cotton wool spot etc)

-ELSCHNIG'S SPOTS

SCHIE'S CLASSIFICATION OF HYPERTENSIVE RETINOPATHY 1953-

CHANGES OF HTN -

stage 0-

no visible vascular abmormality

stage I-

diffuse arteriolar narowing esp in smaller vessels

uniform arteriolar calibre ,no focal constriction

stage II-

more pronounced arteriolar narrowing

focal arteriolar attenuation

stage III-

I + II +
hemorrhages

stage IV-

retinal edema

hard exudates

optic disc edema

ARTERIOLOSCLEROTIC CHANGES-

stage 0 -

normal

stage 1-

broadened arteteriolar light reflex

minimal or no arteriovenous compression

stage2-

1+

more prominent crossing changes

stage 3-

1+2+

copper wire appearance

more av compression

stage 4-

silver wire appearance

crossing changes most severe