Evaluation of retinal abnormalities in essential hypertension: qualitative fundoscopy versus central retinal artery resistance index as indicators of target organ damage.

摘要

PURPOSE: To compare qualitative fundoscopy with resistance index (RI) of the central retinal artery determined using color Doppler examination as indicators of target organ damage in a large population of patients with essential hypertension. METHOD: We compared qualitative fundoscopy and central retinal artery RI (CRARI) in 459 patients with grade I and II essential hypertension. Correlations with left ventricular mass, carotid structural changes, and diastolic function were investigated. The results were analyzed according to the degree of retinopathy (grade I versus grade II) and CRARI (<0.70 versus >or=0.70). All patients underwent carotid sonography, echocardiography, diastolic function, a sonographic examination of the eye with measurement of CRARI, and examination of the fundus oculi. RESULTS: There was no statistical difference in the parameters studied between patients with grade I and patients with grade II retinopathy on fundoscopy. Patients with CRARI >or=0.70 were older and had higher systolic and pulse pressure, more years of hypertension, increased left ventricular mass index, carotid intima media thickness, and diastolic parameters compared with patients with CRARI <0.70 (p < 0.001). A positive correlation was found between CRARI and age, pulse pressure, carotid intima media thickness, systolic blood pressure, and duration of hypertension, whereas a negative correlation was found between CRARI and diastolic parameters. Age, pulse pressure, carotid intima media thickness, and left ventricular mass index were independently related to CRARI. CONCLUSION: Our findings indicate that CRARI is more reliable than traditional fundoscopy in the evaluation of hypertension-induced organ damage and should be used to measure global cardiovascular risk for tailored therapy.