Hypertensive retinopathy

Keith Wagener Barker (KWB) grading

 ophthalmology  Cardiology

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'silver wiring'-++++
'AV nipping'--+++
Cotton wool spots / flame haemorrhages---++
papilloedema----+
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The grading system dates from 1939 and there has been much debate over the value of its clinical use. "Early recognition of hypertensive retinopathy signs remains an important step in the risk stratification of hypertensive patients." [1]

There is a 1974 reproduction of the classic 1939 article (subscription required).

1. Grosso A, Veglio F, Porta M, Grignolo FM, Wong TY. Hypertensive retinopathy revisited: some answers, more questions. Br J Ophthalmol 2005 Jan;89(12):1646-1654. Available from: http://bjo.bmj.com/content/89/12/1646



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