Window to Heart; Ocular Manifestations of Hypertension

High blood pressure (BP) affects not only the heart, kidneys, brain, and large arteries but also the eyes. Retinal, choroidal, and optic nerve circulations undergo pathophysiological changes, resulting in clinical signs referred to as hypertensive retinopathy, hypertensive choroidopathy, and hypertensive optic neuropathy. Systemic hypertension also increases the risk of development of retinal vein and artery occlusion, retinal-arteriolar emboli, retinal arterial macroaneurysm, nonarteritic ischemic optic neuropathy (NAION), and diabetic retinopathy. On the other hand, the eye is the only organ where the blood vessels can be observed directly. Retinal arterioles are similar to the cardiac and cerebral arterioles from the anatomical and physiological standpoint. The evaluation of retinal circulation provides further information of the changes in the microvasculature in the body, which may provide additional information on the cardiovascular or cerebrovascular risk stratification of hypertensive patients [1-3]. The purpose of this review was to summarize the ocular manifestations of systemic hypertension and its clinical implication on cardiovascular and cerebrovascular risk stratification.