摘要
Objective: To evaluate the additional value of funduscopy in the routine manag ement of patients with hypertension. Design: Systematic review. Participants: Ad ults aged 19 or more with hypertensive retinopathy. Data sources: Medline, Embas e, and the Cochrane Library from 1990. Review methods: Studies were included tha t assessed hypertensive retinopathy with blinding for blood pressure and cardiov ascular risk factors. Studies on observer agreement had to be assessed by two or more observers and expressed as a κstatistic. Studies on the association betwe en hypertensive retinopathy and hypertensive organ damage were carried out in pa tients with hypertension. The association between hypertensive retinopathy and c ardiovascular risk was carried out in unselected normotensive and hypertensive p eople without diabetes mellitus. Results: The assessment of microvascular change s in the retina is limited by large variation between observers. The positive an d negative predictive values for the association between hypertensive retinopath y and blood pressure were low (47%to 72%and 32%to 67%, respectively). Associ ations between retinal microvascular changes and cardiovascular risk were incons istent, except for retinopathy and stroke. The increased risk of stroke, however , was also present in normotensive people with retinopathy. These studies did no t adjust for other indicators of hypertensive organ damage. Conclusion: Evidence is lacking that routine funduscopy is of additional value in the management of hypertensive patients.
Objective: To evaluate the additional value of funduscopy in the routine manag ement of patients with hypertension. Design: Systematic review. Participants: Ad ults aged 19 or more with hypertensive retinopathy. Data sources: Medline, Embas e, and the Cochrane Library from 1990. Review methods: Studies were included tha t assessed hypertensive retinopathy with blinding for blood pressure and cardiov ascular risk factors. Studies on observer agreement had to be assessed by two or more observers and expressed as a κstatistic. Studies on the association betwe en hypertensive retinopathy and hypertensive organ damage were carried out in pa tients with hypertension. The association between hypertensive retinopathy and c ardiovascular risk was carried out in unselected normotensive and hypertensive p eople without diabetes mellitus. Results: The assessment of microvascular change s in the retina is limited by large variation between observers. The positive an d negative predictive values for the association between hypertensive retinopath y and blood pressure were low (47%to 72%and 32%to 67%, respectively). Associ ations between retinal microvascular changes and cardiovascular risk were incons istent, except for retinopathy and stroke. The increased risk of stroke, however , was also present in normotensive people with retinopathy. These studies did no t adjust for other indicators of hypertensive organ damage. Conclusion: Evidence is lacking that routine funduscopy is of additional value in the management of hypertensive patients.
出处
《世界核心医学期刊文摘（眼科学分册）》
2005年第11期5-6,共2页
Digest of the World Core Medical Journals:Ophthalmology
