The Role of Thrombotic Microangiopathy in the Development of Retinal Changes in Malignant Arterial Hypertension

Malignant arterial hypertension (MAH) is a severe and life-threatening condition characterized by an abrupt rise in blood pressure leading to end-organ damage, particularly affecting the kidneys, brain, and retina. One of the critical pathological mechanisms involved in MAH is thrombotic microangiopathy (TMA), a process characterized by endothelial injury, microvascular thrombosis, and ischemic tissue damage. In the retina, TMA contributes to severe microvascular dysfunction, leading to hemorrhages, cotton-wool spots, exudates, and even retinal detachment. This paper explores the pathophysiology of TMA in MAH and its direct impact on retinal changes, emphasizing clinical implications and potential therapeutic interventions.