Schulte K, Wolf S, Koch M J, Arend O, Remky A, Ittel T H, Reim M
Augenklinik, Medizinische Fakultät der RWTH, Aachen.
Ophthalmologe. 1993 Oct;90(5):479-85.
Arterial hypertension is a risk factor for the development of retinal, cerebral and renal microangiopathy. Therefore, a prospective study was started to investigate the progression of retinal microangiopathy in hypertensive patients. Initially, 254 patients were examined in a cross-sectional study. Following an ophthalmological examination, retinal hemodynamics were quantified by means of video-fluorescence angiography. Moreover, blood fluidity (hematocrit, plasma viscosity and erythrocyte aggregation) was analyzed. The severity of the retinal changes was defined according to the Neubauer classification. One hundred (40%) patients showed retinal changes corresponding to stage I; 133 (52%) were classified as stage II. Hypertensive retinopathy (stage III and IV) was encountered in 20 (8%) patients. Arm-retina time was significant prolonged among the hypertensive patients compared with a control group. Arteriovenous passage time showed no significant differences between hypertensive patients and reference values. Plasma viscosity was significantly increased in hypertensive patients and showed a significant increase with progression of the retinal changes. Hematocrit and erythrocyte aggregation were normal among the patients studied. The present findings show an alteration in blood fluidity among hypertensive patients, whereas retinal microcirculation showed no significant disturbances. Follow-up studies are planned to assess the development of retinal microcirculatory changes among hypertensive patients.
动脉高血压是视网膜、脑和肾微血管病变发生的一个危险因素。因此,启动了一项前瞻性研究来调查高血压患者视网膜微血管病变的进展情况。最初,在一项横断面研究中对254例患者进行了检查。经过眼科检查后,通过视频荧光血管造影对视网膜血流动力学进行量化。此外,还分析了血液流动性(血细胞比容、血浆粘度和红细胞聚集)。视网膜病变的严重程度根据Neubauer分类进行定义。100例(40%)患者表现出符合I期的视网膜病变;133例(52%)被归类为II期。20例(8%)患者出现高血压性视网膜病变(III期和IV期)。与对照组相比,高血压患者的臂-视网膜时间显著延长。高血压患者的动静脉通过时间与参考值之间无显著差异。高血压患者的血浆粘度显著升高,并且随着视网膜病变的进展而显著增加。在所研究的患者中,血细胞比容和红细胞聚集均正常。目前的研究结果显示高血压患者的血液流动性发生了改变,而视网膜微循环未显示出明显的紊乱。计划进行随访研究以评估高血压患者视网膜微循环变化的发展情况。