Stage Of Hypertension In Patients With
Hypertensive Retinopathy
18 Sep 2020, 20:33 Yogi Ramdani Dibaca : 448
STAGE OF HYPERTENSION IN PATIENTS WITH HYPERTENSIVE RETINOPATHY
Vito Damay*, Antonia Anna*, Endang Johani**
Department of Cardiovascular Medicine, Faculty of Medicine Universitas Pelita Harapan - Siloam Hospital Lippo Village **Department of Ophthalmology, Faculty of Medicine Universitas Pelita Harapan- Siloam Hospital Lippo Village
Abstract For Annual Scientific Meeting of Indonesian Heart Asssociation 2010
Background: Hypertension is associated with cardiovascular risk and systemic target organ damage. Retinopathy is considered one of the indicators of target organ damage. However, the hypertension may be unknown to the patient until the eye exam may reveal the first clue to this relative asymptomatic systemic disease. An elevated blood pressure induced pathophysiological changes to the retinal microvasculature that leads to several characteristic retinal findings. On the basis of the JNC criteria, the presence of hypertensive retinopathy may be an indication for initiating anti-hypertensive treatment, even in people with stage I hypertension whose have no other evidence of target-organ damage. Despite of that recommendation, many physicians do not regularly perform an ophthalmoscopic examination as part of the care they provide to hypertensive patients, nor do they include retinal findings when making decisions about treatment.
Objective: This study purpose is to review a correlation between hypertensive retinopathy and systemic hypertension and to describe distribution of systemic hypertension among patients with retinal finding suggest a hypertensive retinopathy.
Design: This retrospective study was carried out in Out-Patient Department Siloam Hospital Lippo Village taken from Medical Records from February 2009 until February 2010. Result: We had 108 patients with sign of hypertensive retinopathy (total samples) as showed by retinal photography with 82 of them (76%) had an elevated blood pressure, 31 patients (29%) were classified to grade I hypertensive retinopathy according to Keith-Wagener (KW) classification, 47 patients (44%) were classified as KW II, 24 patients (22%) were classified as KW III and 6 patients (5%) were classified as KW IV. Among the hypertensive patients, 67 patients (82%) were classified into Grade II hypertension according to JNC 7 classification. In the group of KW I hypertensive retinopathy patients, 12 patients (38%) were classified as having Grade II systemic hypertension. In group KW II hypertensive retinopathy patients, 29 patients (62%) were classified as having Grade II systemic hypertension, while among 24 patients with KW III hypertensive retinopathy; 20 patients (83%) were having systemic hypertension grade II. All patients that classified as KW IV hypertensive retinopathy were having Grade II systemic hypertension.
Conclusion: This study shows that most of the patients with hypertensive retinopathy suffered from grade II systemic hypertension, and most of them were come and diagnosed of having a KW II hypertensive retinopathy. Most of the patients who diagnosed of having KW II and KW III hypertensive retinopathy also having grade II systemic hypertension. For hypertensive patient without any sign of target organ damage, ophthalmological referral may also be useful and the retinal signs could be a consideration for further management decision.
Pengirim : Vito Damay
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