Which sign is seen in hypertensive retinopathy and indicates more advanced disease, often malignant hypertension?

Which sign is seen in hypertensive retinopathy and indicates more advanced disease, often malignant hypertension?

• A. Papilledema
• B. Cotton-wool spots
• C. Copper wiring
• D. AV nicking

Answer: (A)

Papilledema is the sign that indicates more advanced hypertensive retinopathy, often seen in malignant hypertension. It’s optic disc swelling caused by markedly elevated blood pressure and raised intracranial pressure, reflecting end-organ damage. Earlier retinal changes from hypertension include arteriolar changes like copper wiring and AV nicking, and retinal nerve fiber layer ischemia manifesting as cotton-wool spots, but these do not on their own signify a hypertensive emergency. Papilledema signals a hypertensive crisis requiring urgent evaluation and management.

Papilledema is the sign that indicates more advanced hypertensive retinopathy, often seen in malignant hypertension. It’s optic disc swelling caused by markedly elevated blood pressure and raised intracranial pressure, reflecting end-organ damage. Earlier retinal changes from hypertension include arteriolar changes like copper wiring and AV nicking, and retinal nerve fiber layer ischemia manifesting as cotton-wool spots, but these do not on their own signify a hypertensive emergency. Papilledema signals a hypertensive crisis requiring urgent evaluation and management.