Abstract
Retinal changes in patients with arterial hypertension have been described since the middle of the 19th century. From the famous work by Keith, Wagener, and Barker in 1939 until today, advanced retinal changes assessed by ophthalmoscopy, i.e., grades 3 and 4 of hypertensive retinopathy, as defined according to the traditional classification system established by the aforementioned authors, are indicative of adverse cardiovascular prognosis in patients with arterial hypertension. However, ophthalmoscopy has been repeatedly criticized over the last decades as it was found to be unreliable in mild and moderate arterial hypertension. Therefore, in the last decades, much research effort has been focused on the improvement of imaging technologies that can detect early vascular changes, i.e., arteriolar narrowing, microvascular rarefaction, arteriolar remodeling, and vascular dysfunction among others, in the retinal vascular bed and to assess the prognostic role of these early retinal vascular changes in arterial hypertension.
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