Hypertension and the eye
Hypertension and the eye
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DOI：
10.1097/icu.0b013e3283129779
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发表时间：
2008-11-01
影响因子：
3.7
通讯作者：
Vitale, Albert T.
中科院分区：
文献类型：
--
作者：
DellaCroce, John T.;Vitale, Albert T.
综述目的本文回顾了眼睛系统性高血压的发现以及这些变化如何代表眼睛本身的疾病，以及眼底镜检查结果对整体健康的预测价值。全身性高血压与视网膜微血管系统的明显变化有关，包括视网膜病变、脉络膜病变和视神经病变，并且与眼部血管异常的风险增加有关，例如动脉和静脉闭塞性疾病、视网膜小动脉大动脉瘤形成和栓塞事件。高血压还会增加糖尿病视网膜病变、青光眼和年龄相关性黄斑变性的发生和进展风险。分级系统已被提出，试图将观察到的眼压变化与全身血管疾病的严重程度、发病率和死亡率联系起来。最近的发现数字成像系统和计算机分析的广泛使用以及修订的分级系统使得检查更加精确和可靠。这重新引起了对高血压患者使用常规眼底镜筛查的兴趣，以确定微血管变化，为心血管风险分层和疾病进展提供预后信息。总结使用可靠且可重复的成像技术识别眼底镜检查的早期微血管变化可能成为预防和管理高血压眼部和全身并发症的重要常规筛查方式。
Purpose of reviewThis article reviews the findings of systemic hypertension in the eye and how these changes represent disease in the eye itself, as well as the predictive value of fundoscopic findings in relation to overall health. Systemic hypertension is associated with observable changes in the retinal microvasculature, including retinopathy, choroidopathy and optic neuropathy, as well as with an increased risk of ocular vascular abnormalities such as arterial and venous occlusive disease, retinal arteriolar macroaneurysm formation and embolic events. Hypertension also confers increased risk for development and progression of diabetic retinopathy, glaucoma and age-related macular degeneration. Grading systems have been proposed that attempt to correlate observed ocular hypertensive changes with systemic vascular disease severity, morbidity and mortality.Recent findingsThe widespread availability of digital imaging systems and computer analysis along with revised grading systems has enabled a more precise and reliable examination. This has renewed the interest in the use of routine fundoscopic screening for patients with hypertension in an effort to identify microvascular changes that may provide prognostic information for cardiovascular risk stratification and disease progression.SummaryIdentification of early microvascular changes on fundoscopic examination using reliable and reproducible imaging techniques may become an important and routine screening modality for the prevention and management of both the ocular and systemic complications of hypertension.