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

Abstract

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 ≥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 ≥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. © 2008 Wiley Periodicals, Inc.