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Ophthalmoscopic grading of vessels in hypertension has always been an enigma to ophthalmologists and internists because of the plethora of grading systems proposed, the attempt to correlate vascular changes with prognosis, and the frequent inability to distinguish aging changes from pathologic changes not associated with aging.
Chapter 1 gives an explanation and object of publication of this book. The author states "we decided to standardize the nomenclature of the respective fundus findings in hypertension."
Chapter 2 is a discussion of the types of arteriolar narrowing and includes diffuse, focal, segmental, and irregular narrowness and a description of grading follows.
Next follows a description of the ratio of the arteriolar reflex streak to the width of the blood column (AR/AC), and is graded from 40% to 60% or more.
Changes in tortuosity, branching angles of arterioles, arteriovenous crossing changes, types of hemorrhage, and white spots in the retina (including exudates, drusen,
Kingham JD. Colour Atlas and Criteria of Fundus Changes in Hypertension.. Arch Ophthalmol. 1972;88(3):353-354. doi:10.1001/archopht.1972.01000030355037