Arteriovenous Nicking

  • Indentation (nicking) of retinal veins by stiff (arteriosclerotic) retinal arteries
  • Commonest cause is chronic hypertension
  • Valuable sign of chronic systemic hypertension that has also caused damage to arteries elsewhere in body (heart, kidneys, brain)
  • Using ophthalmoscope, find these vessels at their emergence from optic disc and follow them as far out as you can, looking for arteriovenous nicking, which is usually found within 5 disc diameters of optic disc
  • Measure blood pressure and inquire after other arteriosclerotic risk factors
  • Uncontrolled systemic blood pressure has severe health consequences