AV nicking on fundoscopic exam is commonly associated with which systemic condition?

• A. Glaucoma
• B. Cataracts
• C. Hypertension
• D. Diabetes

Answer: (C)

AV nicking reflects changes in retinal vessels due to long-standing high blood pressure. When arteries become thickened and rigid from hypertension, they compress the underlying crossing venules at arteriovenous crossings, causing the venule to appear narrowed or “nicked.” This sign is a classic finding in hypertensive retinopathy and indicates systemic hypertension and vascular changes from arteriosclerosis.

It’s not characteristic of glaucoma (optic nerve cupping), cataracts (lens opacity), or diabetic retinopathy (microaneurysms, hemorrhages, exudates, and neovascularization). So AV nicking points to hypertension as the underlying association.