Copper wiring of retinal arterioles on fundoscopic exam is typically seen in hypertensive retinopathy of which severity?

Copper wiring of retinal arterioles on fundoscopic exam is typically seen in hypertensive retinopathy of which severity?

• A. Moderate
• B. Mild
• C. Severe
• D. Malignant

Answer: (A)

Copper wiring reflects arteriolar wall thickening from chronic hypertension. The thickened vessel wall enhances the retinal arteriolar light reflex, giving a copper-colored appearance on exam. This arteriolosclerosis indicates sustained high blood pressure and sits after simple vasoconstriction in milder disease but before the more dramatic signs (hemorrhages, exudates, papilledema) seen in severe or malignant hypertensive retinopathy. So copper wiring is most consistent with moderate hypertensive retinopathy.

Copper wiring reflects arteriolar wall thickening from chronic hypertension. The thickened vessel wall enhances the retinal arteriolar light reflex, giving a copper-colored appearance on exam. This arteriolosclerosis indicates sustained high blood pressure and sits after simple vasoconstriction in milder disease but before the more dramatic signs (hemorrhages, exudates, papilledema) seen in severe or malignant hypertensive retinopathy. So copper wiring is most consistent with moderate hypertensive retinopathy.