Information on the following diseases can be found in the Related Disorders section of this report:

• Hypertensive Retinopathy
• Papilledema (Choked Disk)

In Arteriosclerotic Retinopathy the opening (lumen) of the little arteries (arterioles) in the retina is irregular. The retina is the layer of the eyeball that contains the light sensitive nerve cells. This layer also contains a large number of little blood vessels. This disorder causes thickening of the arterial walls which in turn causes the arterioles to become contorted.

Flame shaped or pinpoint spots of bleeding may also occur, although they are apparent only during examination of the eye with an ophthalmoscope. The retina may show oozing of thick liquid, and dying tissue (necrosis) in certain spots. The place where the optic nerve enters the retina (optic disk or papilla) as seen by the ophthalmologist, may be blurred. The retina may become detached, and arterial spasm may occur. Eventually internal bleeding or clotting (thrombosis) of the central vein and withering away (atrophy) of the retina may result, which can cause progressive vision impairment.

Arteriosclerotic Retinopathy usually occurs as a result of progressive hardening of the blood vessels by calcification and loss of elastic tissue (arteriosclerosis). Arteriosclerosis is a general term which includes a number of blood vessel diseases such as fatty degeneration of the arteries (atherosclerosis), and may also include changes in the shape of the arteries. With age, the blood vessels often become more contorted and less elastic. Certain biochemical, physical and environmental factors, known as risk factors may predispose an individual to arteriosclerosis.

Arteriosclerotic Retinopathy affects persons with fatty degeneration (atherosclerosis), and hardening of the arteries (arteriosclerosis). This type of Retinopathy usually affects people over age 50 years

Hypertensive Retinopathy is a syndrome of changes in the retina caused by hypertension. It is characterized by progressive changes in the little arteries (arterioles) of the eye and swelling (edema), resulting in vision impairment. (For more information, choose "hypertensive retinopathy" as your search term in the Rare Disease Database.)

Papilledema (Choked Disk) is a swelling (edema) of the portion of the retina where the optic nerve enters the eyeball. The swelling is due to increased pressure inside the skull that may be caused by a variety of conditions.

Therapy for Arteriosclerotic Retinopathy consists of treating the underlying arteriosclerosis. An excess of lipids in the blood (hyperlipidemia) can be prevented by changes in dietary habits. Fat intake should be reduced, and saturated fats should be replaced with polyunsaturated fats. The intake of cholesterol, saturated and short-chain fatty acids (such as those in meats or dairy products), should be reduced. Weight reduction to normal, or even slightly under current statistical norms, is recommended. Drugs may be required in certain patients to reduce blood cholesterol and lipids.

Prevention of arteriosclerosis is possible by good control of diabetes when present, and by weight loss if obesity is a factor. Cigarette smoking may also aggravate arteriosclerosis and should be limited or stopped. Regular exercise may be a helpful therapeutic measure. Hypertension should be identified and treated early.

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

TEXTBOOKS
Bennett JC, Plum F., eds. Cecil Textbook of Medicine. 20th ed. Philadelphia, PA: W.B. Saunders Co; 1996:2181.

Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:729.

REVIEW ARTICLE
Bhagat N, et al., Central retinal vein occlusion: review of management. Eur J Ophthalmol. 1999;9:165-80.

JOURNAL ARTICLES
Schimkat M, et al., [Mitral valve prolapse. A possible cause of retinal vascular occlusion in young patients]. Ophthalmologe. 1993;90:476-78. German.

Tomikawa S, et al., [Lipoprotein (a) and sclerotic changes in retinal arterioles]. Nippon Ganka Gakkai Zasshi. 1993;97:967-74. Japanese.

Rabb MF, et al., Retinal arterial macroaneurysms. Surv Ophthalmol. 1988;33:73-96.

Trushko IA., [Possibilities of the color stress test in the early diagnosis and evaluation of the effectiveness of treatment of arteriosclerotic retinal dystrophies]. Oftalmol Zh. 1986;4:229-231.