Download - Journal Retinopathy Hipertensive
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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**
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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!"#$%2&
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Original Article 0!pertensi1e
retinopath! CO Omolase
the dierent
gro+ps were
not
statisticall!
signiicant#
2here is
need to
ens+re that
h!pertensi1
es ha1e
reg+lar
oc+lar
e9amination
# Ph!sicians
sho+ld
ens+re
optimal
lood
press+re
control in
h!pertensi1
e patients so
as topre1ent
target organ
damage#
'ey(ords"
0!pertensio
n,
retinopath!,
lood
press+re
control,
Nigeria#
)ntroductio
n
0!pertensio
n ma! ha1e
serio+s
eects on
the
e!es# :t
pla!s an
important
role in a
1ariet! o
ophthalmic
conditions'/
;and is one
o the
most
important
non"
comm+nica
le
disorders in
the world'$;
#
: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
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end organ
damage was
clinicall!
apparent'
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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
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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
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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&
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Original Article 0!pertensi1e
retinopath! CO Omolase
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
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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
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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/
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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//
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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/%)(
$-$"
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Original Article 0!pertensi1e
retinopath! CO Omolase
2heir co+rse
and
prognosis#AM4 Med
Sci
/==H/=3(
$#
0a!re! SS#
Classiicatio
n o
h!pertensi1e +nd+s
changes and
their order
o
appearance#
Ophthalmol
ogical
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Sudan Med J 2!"#$%2&