WordNet

provide a fund for the redemption of principal or payment of interest
a reserve of money set aside for some purpose (同)monetary fund
accumulate a fund for the discharge of a recurrent liability; "fund a medical care plan"
convert (short-term floating debt) into long-term debt that bears fixed interest and is represented by bonds
furnish money for; "The government funds basic research in many areas"
invest money in government securities
place or store up in a fund for accumulation
(of living tissue) in a state of abnormally high tension; "hypertonic muscle tissue"
(of a solution) having a higher osmotic pressure than a comparison solution
(anatomy) the base of a hollow organ or that part of the organ farthest from its opening; "the uterine fundus"; "the fundus of the stomach"

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(特定の目的のための)『資金』,基金《+『for』+『名』》 / 《a ~》(すぐに役立つ知職などの)『蓄え』,蓄積(stock)《+『of』+『名』》 / 《複数形で》手元資金,所持金;《英》公債,国債 / 〈事業・研究など〉‘に'資金を提供する / 〈負債〉‘を'長期公債にする

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/05 01:04:07」(JST)

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Hypertensive retinopathy is damage to the retina and retinal circulation due to high blood pressure (i.e. hypertension).

Pathophysiology

The changes in hypertensive retinopathy result from damage and adaptive changes in the arterial and arteriolar circulation in response to the high blood pressure. ..^{[citation needed]}

Symptoms

Most patients with hypertensive retinopathy present no visual symptoms. However, some may report decreased vision or headaches.^{[citation needed]}

Signs

Signs of damage to the retina caused by hypertension include:

Arteriolar changes, such as generalized arteriolar narrowing, focal arteriolar narrowing, arteriovenous nicking, changes in the arteriolar wall (arteriosclerosis) and abnormalities at points where arterioles and venules cross. Manifestations of these changes include Copper wire arterioles where the central light reflex occupies most of the width of the arteriole and Silver wire arterioles where the central light reflex occupies all of the width of the arteriole, and "arterio-venular (AV) nicking" or "AV nipping", due to venous constriction and banking.
advanced retinopathy lesions, such as microaneurysms, blot hemorrhages and/or flame hemorrhages, ischemic changes (e.g. "cotton wool spots"), hard exudates and in severe cases swelling of the optic disc (optic disc edema), a ring of exudates around the retina called a "macular star" and visual acuity loss, typically due to macular involvement.

Mild signs of hypertensive retinopathy can be seen quite frequently in normal people (3–14% of adult individuals aged ≥40 years), even without hypertension.^[1]

Keith Wagener Barker (KWB) Grades

Grade 1: Arteriolar constriction/attenuation/sclerosis -`silver wiring` and vascular tortuosities
Grade 2: As grade 1 + Irregularly located, tight constrictions - Known as `AV nicking` or `AV nipping`
Grade 3: As grade 2 + Retinal edema, cotton wool spots and flame-hemorrhages
Grade 4: As grade 3 + optic disc edema + macular star

There is an association between the grade of retinopathy and mortality. In a classic study in 1939 Keith and colleagues^[2] described the prognosis of people with differing severity of retinopathy. They showed 70% of those with grade 1 retinopathy were alive after 3 years whereas only 6% of those with grade 4 survived.The most widely used modern classification system bears their name.^[1] The role of retinopathy grading in risk stratification is debated, but it has been proposed that individuals with signs of hypertensive retinopathy signs, especially retinal hemorrhages, microaneurysms and cotton-wool spots, should be assessed carefully.^[1]

Differential Diagnoses

Several other diseases can result in retinopathy that can be confused with hypertensive retinopathy. These include diabetic retinopathy, retinopathy due to autoimmune disease, anemia, radiation retinopathy, central retinal vein occlusion.^{[citation needed]}

Treatment and management

A major aim of treatment is to prevent, limit, or reverse target organ damage by lowering the patient's high blood pressure and reduce the risk of cardiovascular disease and death. Anti-hypertensive drug treatment may be required to control the high blood pressure.

References

^ ^a ^b ^c Wong TY, Mcintosh R (2005). "Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality". British Medical Bulletin. 73-74: 57–70. doi:10.1093/bmb/ldh050. PMID 16148191.
^ Keith NM, Wagener HP, Barker NW (1939) Some different types of essential hypertension: their course and prognosis. Am J Med Sci, 197, 332–43.

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English Journal

[Fundus hypertonicus Okulare Veranderungen bei systemischen Erkrankungen].

Schnurrbusch UE, Wolf S.SourceKlinik und Poliklinik fur Augenheilkunde, Inselspital, Universitat Bern, Bern, Schweiz.
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft.Ophthalmologe.2005 Mar;102(3):301-11; quiz 312.
Cardiovascular disease is one of the major causes of mortality and morbidity in the western world. However, 30% of men and 15% of women were not aware of their elevated blood pressure. Hypertension has been defined as a multiply exceeded threshold value set by the WHO. With increasing blood pressure
PMID 15688200

Hyponatremia-induced transient visual disturbances in acute spinal cord injury.

Karlsson AK, Krassioukov AV.SourceSpinal Cord Injury Unit, Institution of Clinical Neuroscience, Sahlgrenska Academy, Goteborg, Sweden.
Spinal cord.Spinal Cord.2004 Mar;42(3):204-7.
STUDY DESIGN: Case report and literature review.OBJECTIVE: To report an unusual case of prolonged hyponatremia in acute cervical spinal cord injury complicated by visual disturbances and to review the literature regarding the issue.SETTINGS: Spinal Cord Injury Unit in Goteborg, Sweden.METHODS: Retr
PMID 15001983

「高血圧性眼底」

Hypertensive retinopathy
	Hypertensive retinopathy with AV nicking and mild vascular tortuosity
Classification and external resources
Specialty	ophthalmology
ICD-10	H35.0
ICD-9-CM	362.11
MedlinePlus	000999
MeSH	D058437
	[edit on Wikidata]

　　[★]

英: hypertonic fundus
ラ: fundus hypertonicus
同: 高血圧眼底
関: 高血圧性網膜症

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高血圧眼底 : 約 562 件
高血圧性眼底 : 約 10,500 件

「fundus」

　　[★]

n.

底、胃底、眼底、基底

関: basal、basement、bases、basis、eyeground、floor、fundal、fundi、fundus oculi、gastric fundus、ground、ocular fundus、stomach fundus

「hypertonic」

　　[★]

adj.

高浸透圧性の、高張の、高張性の、高塩濃度の

関: hyperosmolality、hyperosmolar、hyperosmolarity、hyperosmotic、hypertonicity

「fund」

　　[★]

n.

基金

v.

資金を提供する

関: endowment、foundation

[Wong_2005-1] Wong TY, Mcintosh R (2005). "Hypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality". British Medical Bulletin. 73-74: 57–70. doi:10.1093/bmb/ldh050. PMID 16148191.

[2] Keith NM, Wagener HP, Barker NW (1939) Some different types of essential hypertension: their course and prognosis. Am J Med Sci, 197, 332–43.

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関連記事	「fundus」「hypertonic」「fund」

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fundus hypertonicus