ТЕХНИЧЕСКИЕ, КЛИНИЧЕСКИЕ И ПРОГНОСТИЧЕСКИЕ АСПЕКТЫ ГИПЕРТЕНЗИВНОЙ РЕТИНОПАТИИ
Аннотация
Изменения подходов к ведению пациентов с артериальной гипертензией, отраженные в рекомендациях международного уровня, касающиеся в том числе и диагностики, определения сердечно-сосудистого риска, потребовало вновь вернуться к вопросу о месте фундоскопии в рутинной клинической практике. В последних исследованиях уточнена распространенность разных вариантов ретинопатии с использованием новых, высокоточных инструментов. Большое число работ посвящено изучению прогностической роли фундоскопии, и здесь мнение исследователей однозначно: обнаружение признаков начальных стадий ретинопатии слабо влияет на ведение пациентов. Следует согласиться с мнением экспертов европейского кардиологического общества, что проведение фундоскопии в основном показано у пациентов с трудно контролируемой или резистентной артериальной гипертензией, но не рекомендуется у лиц с мягкой и умеренной гипертензией, не страдающих диабетом, за исключением молодых пациентов.
Литература
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur. Heart J. 2018;39(33):3021-3104. https://doi.org/10.1093/eurheartj/ehy339
Gunn RM. Ophthalmoscopic evidence of (1) arterial changes associated with chronic renal diseases and (2) of increased arterial tension. In: Ophthalmological Society of the United Kingdom. Transactions of the Ophthalmological Society of the United Kingdom. London: JA Churchill; 1982. Vol. 12; p. 124-125.
Breslin DJ, Gifford RWJ, Fairbairn JF, Kearns TP. Prognostic importance of ophthalmoscopic findings in essential hypertension. JAMA.1966;195(5):335-338. https://doi.org/10.1001/jama.1966.03100050043015
Klein R, Klein BE, Moss SE, Wong TY. The relationship of retinopathy in persons without diabetes to the 15-year incidence of diabetes and hypertension: beaver dam eye study. Trans Am Ophthalmol Soc. 2006;104:98-107.
Jeganathan VSE, Cheung N, Tay WT, Wang JJ, Mitchell P, Wong TY. Prevalence and Risk Factors of Retinopathy in an Asian Population without Diabetes: the Singapore Malay Eye Study. Arch Ophthalmol. 2010;128(1):40-45. https://doi.org/10.1001/archophthalmol.2009.330
Hirai FE, Moss SE, Knudtson MD, Klein BE, Klein R. Retinopathy and survival in a population without diabetes: The Beaver Dam Eye Study. Am J Epidemiol. 2007;166(6):724-730. https://doi.org/10.1093/aje/kwm126
Gunnlaugsdottir E, Halldorsdottir S, Klein R, Eiriksdottir G, Klein BE, Benediktsson R, Harris TB, Launer LJ, Aspelund T, Gudnason V, Cotch MF, Jonasson F. Retinopathy in old persons with and without diabetes mellitus: the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-R). Diabetologia. 2012;55(3):671-680. https://doi.org/10.1007/s00125-011-2395-y
Sirenko YuM, Mishchenko LA, Jena LM, Koval SM, Radchenko GD, Rekoveс OL. Klasyfikacija ta standarty nadannja medychnoi dopomogy hvorym na arterialnu gipertenziju Asociacii kardiologiv Ukrainy. Proekt [Classification and standards of providing medical care for patients with arterial hypertension of the Ukrainian Association of Cardiology. Project] Arterialnaja gipertenzija. 2018;4(60):32-53. https://doi.org/10.22141/22241485.4.60.2018.141955 (Ukrainian).
Lehmann MV, Schmieder RE. Remodeling of Retinal Small Arteries in Hypertension. Am J Hypertens. 2011;24(12):1267-1273. https://doi.org/10.1038/ajh.2011.166
Kolman SA, van Sijl AM, van der Sluijs FA, van de Ree MA. Consideration of hypertensive retinopathy as an important end-organ damage in patients with hypertension. J Hum Hypertens. 2017;31(2):121-125. https://doi.org/10.1038/jhh.2016.49
Erden S, Bicakci E. Hypertensive retinopathy: incidence, risk factors, and comorbidities. Clin Exp Hypertens. 2012;34(6):397-401. https://doi.org/10.3109/10641963.2012.663028
Chen X, Meng Y, Li J, She H, Zhao L, Zhang J, Peng Y, Shang K, Zhang Y, Gu X, Yang W, Zhang Y, Li J, Qin X, Wang B, Xu X, Hou F, Tang G, Liao R, Huo Y, Yang L. Serum uric acid concentration is associated with hypertensive retinopathy in hypertensive Chinese adults. BMC Ophthalmol. 2017;17:83. https://doi.org/10.1186/s12886-017-0470-y
Del Brutto OH, Mera RM, Viteri EM, Pólit J, Ledesma EA, Cano JA, Plaza KJ, Zambrano M, Costa AF. Hypertensive retinopathy and cerebral small vessel disease in Amerindians living in rural Ecuador: The Atahualpa Project. Int J Cardiol. 2016;218:65-68. https://doi.org/10.1016/j.ijcard.2016.05.020
Zhang Y, Zhao L, Li H, Wang Y. Risk factors for hypertensive retinopathy in a Chinese population with hypertension: The Beijing Eye study. Exp Ther Med. 2019;17(1):453-458. https://doi.org/10.3892/etm.2018.6967
Reichhart N, Haase N, Crespo-Garcia S, Skosyrski S, Herrspiegel C, Kociok N, Fuchshofer R, Dillinger A, Poglitsch M, Müller DN, Joussen AM, Luft FC, Dechend R, Straub O. Hypertensive retinopathy in a transgenic angiotensin-based model. Clin Sci. 2016;130(13):1075-1088. https://doi.org/10.1042/CS20160092
Pache M, Kube T, Wolf S, Kutschbach P. Do angiographic data support a detailed classification of hypertensive fundus changes? J Hum Hypertens. 2002;16(6):405-410. https://doi.org/10.1038/sj.jhh.1001402
Celujko VJ, editor. Kurs lekcij z klinichnoi kardiologii. Harkiv: Gryf; 2004. 576 р. (Ukrainian).
Chatterjee S, Chattopadhyay S, Hope-Ross M, Lip PL. Hypertension and the eye: changing perspectives. J Hum Hypertens. 2002;16(10):667-675. https://doi.org/10.1038/sj.jhh.1001472
Wong TY, Mitchell P. Hypertensive retinopathy. N Engl J Med. 2004;351(22):2310-2317. https://doi.org/10.1056/NEJMra032865
Aissopou EK, Papathanassiou M, Nasothimiou EG, Konstantonis GD, Tentolouris N, Theodossiadis PG, Papaioannou TG, Sfikakis PP, Protogerou AD. The Keith-Wagener-Barker and Mitchell-Wong grading systems for hypertensive retinopathy: association with target organ damage in individuals below 55 years. J Hypertens. 2015;33(11):2303-2309. https://doi.org/10.1097/HJH.0000000000000702
Dimmitt SB, West JN, Eames SM, Gibson JM, Gosling P, Littler WA. Usefulness of ophthalmoscopy in mild to moderate hypertension. Lancet. 1989;1(8647):1103-1106. https://doi.org/10.1016/S0140-6736(89)92384-2
Rizzoni D, Porteri E, Duse S, De Ciuceis C, Rosei CA, La Boria E, Semeraro F, Costagliola C, Sebastiani A, Danzi P, Tiberio GA, Giulini SM, Docchio F, Sansoni G, Sarkar A, Rosei EA. Relationship between media-to-lumen ratio of subcutaneous small arteries and wall-to-lumen ratio of retinal arterioles evaluated noninvasively by scanning laser Doppler flowmetry. J Hypertens. 2012;30(6):1169-1175. https://doi.org/10.1097/HJH.0b013e328352f81d
Struijker-Boudier HAJ, Agabiti-Rosei E. The microcirculation and the haemodynamics of hypertension. European Society of Hypertension Scientific Newsletter: Update on Hypertension Management. 2008;9(34):1-2.
Perrone-Filardi P, Coca A, Galderisi M, Paolillo S, Alpendurada F, de Simone G, Donal E, Kahan T, Mancia G, Redon J, Schmieder R, Williams B, Agabiti-Rosei E. Noninvasive cardiovascular imaging for evaluating subclinical target organ damage in hypertensive patients: a consensus article from the European Association of Cardiovascular Imaging, the European Society of Cardiology Council on Hypertension and the European Society of Hypertension. J Hypertens. 2017;35(9):17271741. https://doi.org/10.1097/HJH.0000000000001396
Chang CH, Tsai RK, Wu WC, Kuo SL, Yu HS. Use of dynamic capillaroscopy for studying cutaneous microcirculation in patients with diabetes mellitus. Microvasc Res. 1997;53(2):121-127. https://doi.org/10.1006/mvre.1996.2003
Ushiyama O, Ushiyama K, Yamada T, Koarada S, Tada Y, Suzuki N, Ohta A, Nagasawa K. Retinal findings in systemic sclerosis: a comparison with nailfold capillaroscopic patterns. Ann Rheum Dis. 2003;62(3):204-207. https://doi.org/10.1136/ard.62.3.204
Arend O, Rüffer M, Remky A. Macular circulation in patients with diabetes mellitus with and without arterial hypertension. Br J Ophthalmol. 2000;84(12):1392-1396. https://doi.org/10.1136/bjo.84.12.1392
Hanff TC, Sharrett AR, Mosley TH, Shibata D, Knopman DS, Klein R, Klein BE, Gottesman RF. Retinal microvascular abnormalities predict progression of brain microvascular disease: an atherosclerosis risk in communities magnetic resonance imaging study. Stroke. 2014;45(4):1012-1017. https://doi.org/10.1161/STROKEAHA.113.004166
Wei W, Xia Z, Gao H, Gong J, Yan L, Huang Y, Chen F, Zhang W. Correlation of retinopathy with leukoaraiosis in patients with anterior circulation infarcts. J Clin Neurosci. 2016;33:105-110. https://doi.org/10.1016/j.jocn.2016.02.042
Varghese M, Adhyapak SM, Thomas T, Sunder M, Varghese K. The association of severity of retinal vascular changes and cardiac remodelling in systemic hypertension. Ther Adv Cardiovasc Dis. 2016;10(4):224-230. https://doi.org/10.1177/1753944716630869
Triantafyllou A, Anyfanti P, Zabulis X, Gavriilaki E, Karamaounas P, Gkaliagkousi E, Petidis K, Pyrpasopoulou A, Girasis C, Aslanidis S, Douma S. Accumulation of microvascular target organ damage in newly diagnosed hypertensive patients. J Am Soc Hypertens. 2014;8(8):542549. https://doi.org/10.1016/j.jash.2014.04.008
Janisch B, Giezendanner S, Henny-Fullin K, Buess D, Handschin A, Zeller A, Leuppi JD, Dieterle T. The relation of arterial hypertension and target organ damage in the swiss hypertension cohort study. J Hypertens. 2017;35(Suppl 2):e271. https://doi.org/10.1097/01.hjh.0000523786.70737.00
Duarte T, Gonçalves S, Brito R, Sa C, Marinheiro R, Fonseca M, Rodrigues R, Seixo F, Guerreiro A, Fernandes A, Carradas C, Silvestre I, Bernardino L, Caria R. Relationship between nocturnal blood pressure profiles and the presence and severity of hypertensive retinopathy. Rev Port Cardiol. 2018;37(2):169-173. https://doi.org/10.1016/j.repc.2017.06.009
Karadag B, Ozyigit T, Serindag Z, Ilhan A, Ozben B. Blood pressure profile is associated with microalbuminuria and retinopathy in hypertensive nondiabetic patients. Wien Klin Wochenschr. 2018;130(5-6):204-210. https://doi.org/10.1007/s00508-017-1270-3
Boev SS, Dotsenko MYa, Herasimenko LV, Shekhunova IO. Aktualni aspekty variabelnosti arterialnogo tysku pry arterialnij gipertenzii [Topical aspects of blood pressure variability in hypertension] Arterialnaja gipertenzija. 2018;2(58):44-51. https://doi.org/10.22141/2224-1485.2.58.2018.131065 (Ukrainian).
Roy PK, Nguyen UT, Bhuiyan A, Ramamohanarao K. An effective automated system for grading severity of retin al arteriovenous nicking in colour retinal images. Annu Int Conf IEEE Eng Med Biol Soc. 2014;2014:6324-6327. https://doi.org/10.1109/EMBC.2014.6945075
van den Born BJ, Hulsman CA, Hoekstra JB, Schlingemann RO, van Montfrans GA. Value of routine funduscopy in patients with hypertension: systematic review. BMJ. 2005;331(7508):73. https://doi.org/10.1136/bmj.331.7508.73
Konstantinidis L, Guex-Crosier Y. Hypertension and the eye. Curr Opin Ophthalmol. 2016;27(6):514-521. https://doi.org/10.1097/ICU.0000000000000307
Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F; Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281-357. https://doi.org/10.1097/01
Hughes AD, Stanton AV, Jabbar AS, Chapman N, Martinez-Perez ME, McG Thom SA. Effect of antihypertensive treatment on retinal microvascular changes in hypertension. J Hypertens. 2008;26(8):1703-1707. https://doi.org/10.1097/HJH.0b013e328304b072
