Aftab Hussain Shah, Partab Rai, Ghulam Yasin Abro, Aneel Kumar.
Analysis of retinal signs in patients with primary hypertension.
J Liaquat Uni Med Health Sci Jan ;12(1):17-21.

OBJECTIVE OF STUDY: To detect retinal signs in patients with primary hypertension. DESIGN OF STUDY: Hospital based prospective study. PLACE OF STUDY: Department of Medicine Unit II, Chandka Medical College Hospital Larkana. DURATION OF STUDY: One year from January 2010 to December 2010. MATERIAL AND METHODS: Our study included evaluation of 495 patients of age greater than 20 years with primary systemic hypertension (BP>139/89mmHg) for presence of retinopathy. The hypertension was detected by physician with sphygmomanometer and the retinopathy was detected by ophthalmologist with fundoscopy. The type and severity of hypertensive retinopathy was graded on the basis of KEITH-WAGENER CLASSIFICATION. The investigations advised were complete blood cell count, complete urine examination; sugar fasting, lipid profile, blood urea, serum creatinine, electrocardiogram, echocardiography and X-Ray chest PA-view. Only known patients of primary hypertension were included in this study and patients of primary hypertension with other retinal vessel diseases and secondary hypertension were excluded. RESULTS: We evaluated 495 patients, 317(64.04%) males and 178 (35.95%) females aged 20 years and above. (P value=<0.001, X2 Value=34.29, df=4). The hypertensive retinopathy was present in 223(45.1%) patients and absent in 272(54.9%) patients (P value= <0.045, X2 value=6.19, df=2). The severity and grading of retinopathy seen was, grade-I hypertensive retinopathy in 108 (48.4%,n=223) patients, grade-II in 71(31.8%, n=223), grade-III retinopathy in 36(16.1%, n=223) patients and grade-IV in 8 (3.6%, n=223) patients. (P value=<0.0001, X2 Value=52.76, df=6). CONCLUSION: With early detection of retinal signs in primary hypertensive patients, the eyes and other systemic complications of primary hypertension can be prevented.

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