Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
Anand Bajaj Retina Institute, Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India.
J Nepal Health Res Counc. 2023 Mar 7;20(3):577-585. doi: 10.33314/jnhrc.v20i3.4273.
Hypertensive retinopathy is a common complication among people with hypertension. The current study assessed the risk stratification on systemic target organ involvement of people with hypertensive retinopathy.
In a hospital- based cross-sectional study conducted at a tertiary referral eye institute in Nepal, we included consecutive people ≥ 31 years with essential hypertension. Details of histories and systemic target organ involvements were documented. People with un-gradable retinal findings of hypertensive retinopathy and prior retinal surgery were excluded. All participants underwent comprehensive eye examination, including dilated fundus examination. Hypertensive retinopathy was classified by Modified Scheie classification. Multivariate analysis was performed to identify the risks for hypertensive retinopathy and target organ involvement.
The study recruited 312 subjects. The mean age was 63.68 ± 12.63 years. The mean duration of hypertension was 7.0 ± 6.5 years. Hypertensive retinopathy was detected in 83.7% (n=261) people and 63.5% (n= 198) had grade 1 hypertensive retinopathy. Target organ involvement was detected in 20.5% (n =64) people. These included cardiac (12.5%; n=39), central nervous (5.1%; n= 16), and renal (4.5%; n=14) systems. In multivariate analysis, concurrent hyperlipidaemia was significantly associated with hypertensive retinopathy and target organ involvement. Target organ involvement increased with the severity of hypertensive retinopathy.
Over four-fifths of people with hypertension had hypertensive retinopathy and one-fifth had other systemic target organ involvements. Severity of hypertensive retinopathy and concurrent hyperlipidaemia were associated with target organ involvement. Hypertensive retinopathy can be considered for risk stratification to other target organ involvement in a clinical setting.
高血压性视网膜病变是高血压患者常见的并发症。本研究评估了高血压性视网膜病变患者全身靶器官受累的风险分层。
在尼泊尔一家三级转诊眼科研究所进行的一项基于医院的横断面研究中，我们纳入了连续的年龄≥31 岁的原发性高血压患者。记录了病史和全身靶器官受累的详细信息。排除了高血压性视网膜病变视网膜发现不可分级和既往视网膜手术的患者。所有参与者均接受了全面的眼部检查，包括散瞳眼底检查。高血压性视网膜病变采用改良 Scheie 分类法进行分类。采用多变量分析确定高血压性视网膜病变和靶器官受累的风险。
本研究共招募了 312 名受试者。平均年龄为 63.68±12.63 岁。高血压的平均病程为 7.0±6.5 年。83.7%（n=261）的人患有高血压性视网膜病变，63.5%（n=198）患有 1 级高血压性视网膜病变。20.5%（n=64）的人发现有靶器官受累。这些包括心脏（12.5%；n=39）、中枢神经系统（5.1%；n=16）和肾脏（4.5%；n=14）系统。多变量分析显示，同时患有高脂血症与高血压性视网膜病变和靶器官受累显著相关。靶器官受累随着高血压性视网膜病变的严重程度而增加。
五分之四以上的高血压患者患有高血压性视网膜病变，五分之一的患者有其他全身靶器官受累。高血压性视网膜病变的严重程度和同时患有高脂血症与靶器官受累有关。在临床环境中，可以考虑高血压性视网膜病变进行风险分层，以评估其他靶器官受累的风险。
