A 67-year-old male presents with anaphasic CVA and silver-wire appearance of retinal vessels. What is the most likely cause of these ocular findings?

The ocular findings of "silver-wire appearance of retinal vessels" are characteristic of hypertensive retinopathy, which is associated with chronic high blood pressure. This condition leads to significant changes in the retinal blood vessels, including narrowing and increased reflectivity, giving the vessels a silver-like appearance. In patients with longstanding hypertension, the effects on local circulation can impair the retinal vasculature, contributing to these distinctive clinical findings.

Hypertensive retinopathy can also occur alongside other symptoms related to hypertension, such as anaphasic cerebrovascular accident (CVA), which suggests that the hypertension is not being well controlled and may be contributing to both the retinal changes and the neurological events. This interplay indicates that systemic hypertension has significant effects not just on neurological health but also on eye health.

Other conditions mentioned may present with retinal findings, but they do not typically produce the "silver-wire" appearance. For instance, diabetic retinopathy usually leads to different types of retinal changes, such as microaneurysms and exudates, while cytomegalovirus retinitis may present with retinal necrosis and hemorrhages rather than vessel appearance changes. Sickle cell retinopathy involves changes associated with occlusion and ischemia but does not typically show a silver