How is hypertensive chorioretinopathy diagnosed?

• A. Consistent retinal changes
• B. Systolic blood pressure greater than 160 mmHg
• C. CBC/Chem/T4/UA
• D. All of the above

Answer: (D)

Hypertensive chorioretinopathy arises from severe systemic hypertension and shows a predictable pattern of retinal changes, but a confident diagnosis comes from tying those eye findings to the patient’s blood pressure and overall systemic status. On exam, you’d expect consistent hypertensive retinal signs such as arteriolar narrowing, flame-shaped hemorrhages, cotton-wool spots, and sometimes disc edema in more advanced cases. When you also document markedly elevated systolic blood pressure, it reinforces that the retinal changes are due to hypertension rather than another retinal disease. The basic laboratory workup—CBC, chemistry, urinalysis—helps assess organ involvement and overall burden of hypertension, supporting the systemic context in which the eye findings occur. So the most complete diagnostic picture combines the retinal signs with evidence of severe hypertension and a broad systemic assessment.