journal retinopathy hipertensive

7/26/2019 Journal Retinopathy Hipertensive

1/28

Original Article

Hypertensive retinopathy in a Nigerian community

CO Omolase, FWACS, FMCOphth*, O Adekanle, FMCP**, BO Omolase, MBBS**

Federal Medical Centre, Owo, Ondo State, Nigeria Department o Ophthalmolog!*, Department o

Medicine**

"!

" "

""**"* **

*

**

#&%$#"!

%$#

34302/"1/,0'/.-,+(#) ' &5# #

6789 :9; 6789 ?@0A3> ?20B@

$ &%$#"!&;(

#

&


2/28

2/& (CDDE@B02* ;

# $%%&;=#0> 7896& 'G?F&5; ;&(I0&H ;@LK,J> NM&(

OGP&; &(

H?(I #;A/26/2

(F/)

@Q -/,0

6789


3/28

o the respondents had good lood press+re

control, -. had air lood press+re control

and /%. had poor lood press+re control#

Conclusion 0!pertensi1e retinopath!

occ+rred in onl!

//. o patients and more than hal o them

were o grade # Blood press+re control

aected the pre1alence o h!pertensi1e

retinopath!, howe1er, the dierences amongst

Abstract 2his st+d! was designed todetermine the pre1alence o h!pertensi1e

retinopath! amongst h!pertensi1es presenting

to the medical o+tpatient department o

Federal

Medical Centre,Owo,Ondo State ,Nigeria#

Methodology 2he st+d! was cond+cted

etween Septemer

$%%3 and 4an+ar! $%%One h+ndred

consenting h!pertensi1es were inter1iewed

! the a+thors +sing a semi"str+ct+red

5+estionnaire# All the respondents had

666666666666666666666666666666666

Correspondent author Dr Omolase Charles

Ol+wole Department o Ophthalmolog!,Federal Medical Centre, PMB /%-, Owo,

Ondo State, Nigeria 7mail(

omolash$%%%8!ahoo#com

79 Sudan Med J 2!"#$%2&


4/28

Original Article 0!pertensi1e

retinopath! CO Omolase

the dierent

gro+ps were

not

statisticall!

signiicant#

2here is

need to

ens+re that

h!pertensi1

es ha1e

reg+lar

oc+lar

e9amination

# Ph!sicians

sho+ld

ens+re

optimal

lood

press+re

control in

h!pertensi1

e patients so

as topre1ent

target organ

damage#

'ey(ords"

0!pertensio

n,

retinopath!,

lood

press+re

control,

Nigeria#

)ntroductio

n

0!pertensio

n ma! ha1e

serio+s

eects on

the

e!es# :t

pla!s an

important

role in a

1ariet! o

ophthalmic

conditions'/

;and is one

o the

most

important

non"

comm+nica

le

disorders in

the world'$;

#

:t aects

appro9imat

el! one"illion

people

worldwide

and it is the

most

important

modiiale

risk actor

or

stroke',),-;

#

0!pertensio

n acts as a

silent killer

man! !ears

eore o1ert


5/28

end organ

damage was

clinicall!

apparent'


6/28

disease o

the e!e

similar to

diaetic

retinopath!'

/-"/3;

#

2he e!e is

an end

arteriolar

s!stem and

is thereore

s+sceptile

to changes

in lood

press+re#

2he e!e is

the onl!

place where

lood

1essels can

e 1iewed

! non

in1asi1etechni5+es

'&

;# ?ecent

st+dies

re1ealed

that rom

pathogenic

point o

1iew

1ario+s+nd+s

lesions in

malignant

h!pertensio

n consist o

three

distinct

categories(

h!pertensi1

e

retinopath!,

h!pertensi1

e optic

ne+ropath!

and

h!pertensi1

e

choroidopat

h!# 2he irst

and most

widel! +sed

classiicatio

n o

h!pertensi1

e +nd+s

changes has

een that o

@eith et

al'/&;

# One

o the

limitations

o this

classiicatio

n is that not

all the cases

all into one

o the o+r

deined

categories'/

=;#

0!pertensi1

e

retinopath!

represents

target organ

damage in


7/28

patients

with high

s!stemic

arterial

lood

press+re

and was

irst

descried

!

>iereich in

/&-=#

S+stained

h!pertensio

n leads to

disr+ption

o the

lood"

retinal

arrier,

increased

1asc+lar

permeailit

! and

secondar!

arteriosclero

sis'=;

#

Anormal

1asc+lar

permeailit

! prod+ces

lame

shaped

haemorrhag

es, retinal

oedema and

lipid

e9+dates'$%;

#

:n 1iew o

the retinal

changes

associated

with

s!stemic

h!pertensio

n this st+d!

was

designed to

e1al+ate the

pre1alence

o

h!pertensi1

e

retinopath!

amongst

h!pertensi1

es

presenting

to the

medical

o+tpatient

o Federal

Medical

Centre,

Owo, Ondo

State,

Nigeria#

Methodolo

gy

7thical

appro1al

was

otained

rom

7thical

Committee

o Federal

Medical

Centre,

Owo prior

to carr!ing

o+t this

st+d!# 2his

st+d! was

cond+cted

at the e!e


8/28

clinic o the

hospital

etween

Septemer

$%%3 and

4an+ar!

$%% 2he

cases o

cataract and

other

conditions

impairing

the +ndal

clarit! and

those with

other

s!stemic

conditions

like

diaetes

mellit+s

were

e9cl+ded

rom the

st+d!#

Patients

were

laeled as

h!pertensi1

e when their

lood

press+re

meas+red at

least twice

d+ring twoseparate

occasions

ater the

initial

screening

was e5+al

to or higher

than /)%=%

mm0g

according to

4NC /

classiicatio

n#/%

0!pertensi1

es whose

lood

press+re

was

/)%=%

mm0g were

regarded as

ha1ing good

lood

press+re

control#

2hose with

air control

had loodpress+re o

/)%"/3==%"

/%= mm0g

while those

with poor

lood

press+re

control had

lood

press+re

f/&%//%mm0g#

*

Sudan Med J 2!"#$%2&


9/28



Patients

who are

knownh!pertensi1

es with the

BP /)%=%

were

regarded as

ha1ing good

control# One

h+ndred

consenting

respondents

were

selected !

simple

random

sampling

and

inter1iewed

with the aid

o the st+d!instr+ment

'5+estionnai

re; ! the

a+thors#

:normed

consent was

otained

rom each

o the

respondents#

:normation

otained

incl+ded

their io"

data and

d+ration o

h!pertensio

n #

:normation

ao+t their

control o

lood

press+re

was

otained

rom their

case notes#

All the

patients had

+ndoscop!

carried o+t

! thea+thor

responsile

or

corresponde

nce +sing a

direct

ophthalmos

cope#

2hose with

earl! lens

opacities

had dilated

+ndoscop!#

2he dilation

o the p+pils

was eected

withtropicamide

e!e drop#

0!pertensi1

e

retinopath!

was

classiied

ased on the

classiicatio

n o @eith et


10/28

al'/&;

# rade

/ consists o

mild

generaliEed

retinal

arteriolar

narrowing#

rade $

consist o

more se1ere

generaliEed

narrowing,

ocal areas

o arteriolar

narrowing

and arterio"1eno+s

'A;

nicking#

rade

consists o

grade/ and

grade $

signs pl+s

the presence

o retinalhaemorrhag

es,

microane+r

!sm, hard

e9+dates

and cotton

wool spots#

rade )

sometimes

reerred to

as

accelerated

'malignant;

h!pertensi1

e

retinopath!

consists o

all signs in

the

preceding

three grades

pl+s optic

disc

swelling

and mac+lar

oedema#

Data

otained

with the aid

o the st+d!

instr+ment

was collated

and

anal!Eed

with SPSS

/$#/#%

statistical

sotware

package#

Cross

ta+lation

was done as

well as Chi"

s5+are test#

Statisticalsigniicance

was P

%#%-#

+esults

2here were

one h+ndred

respondentsaged

etween )"

&% !ears#

2here were

)% males

and


11/28

married

while /)

were

widowed#

2went! nine

o the

respondents

each had

tertiar!

ed+cation

and

secondar!

ed+cation

respecti1el!#Nineteen

had no

ed+cation

and

$ had

primar!

ed+cation#

2he

occ+pation

o the

respondents

as detailed

in 2ale /

showed that

maorit! o

them '&.;

weretraders#

,able !"

Occupation o-

the

respondents

Occupation

.re/uency

0ercentage

Farming

/#

0!pertensi1

e and the

7!e(changing

perspecti1e#

4 0+m

0!pertens

$%%$H/


23/28

and

treatment o

high lood

press+re

'4NC:;

Arch :ntern

Med

/==3H/i

W, Wang 44#

?etinopath!

in older

persons

witho+t

diaetes

and its

relationship

to

h!pertensio

n# Arch

Ophthalmol

/==&H//


24/28

BM4

/==&H/3(3%

"/#

G@

Prospecti1eDiaetes

St+d!

ro+p#

7icac! o

atenol and

captopril in

red+cing

risk o

micro1asc+l

ar and

micro1asc+l

ar

complicatio

ns in t!pe o

diaetes

G@PDS

BM4 /==&H

/3(3/"=#

Solie Ak,

Stephenson

4, Aldington

S, et al#

?etinopath!

and 1ision

loss in

ins+lin

dependent

diaetes in

7+rope# 2he

7G?OD:A

B :DDM

Complicati

ons St+d!

Ophthalmol

og!

/==3H/%)(

$-$"


25/28



2heir co+rse

and

prognosis#AM4 Med

Sci

/==H/=3(

$#

0a!re! SS#

Classiicatio

n o

h!pertensi1e +nd+s

changes and

their order

o

appearance#

Ophthalmol

ogical

/=&=H/=&($)

3"


26/28

$%%)H$&(


27/28


28/28

*#

Sudan Med J 2!"#$%2&

journal retinopathy hipertensive

Documents