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  • SCImago Journal Rank (SJR):0,11
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doi: 10.1016/S1889-1837(04)71819-X
Importancia de la valoración del fondo de ojo en el paciente hipertenso
Importance of fundoscopic examination in hypertensive patients
C. Roldán Suárez, , J. Segura de la Morena, C. Campo Sien, J.M. Alcázar de la Ossa
Unidad de Hipertensión. Hospital 12 de Octubre. Madrid. España
Received 25 July 2003, Accepted 18 November 2003
Abstract

La hipertensión arterial (HTA) es el principal factor de riesgo para el desarrollo de enfermedades cardiovasculares y también de lesiones vasculares en la retina. Las alteraciones oculares de la HTA incluyen tres manifestaciones distintas e independientes en la retina, nervio óptico y circulación coroidal. El estudio oftalmológico realizado de forma habitual en todo paciente hipertenso ayuda a valorar la gravedad de la hipertensión. Las últimas guías de la European Society of Hypertension-European Society of Cardiology (ESH/ESC) incluyen el examen fundoscópico dentro de los métodos para evaluar la lesión de órgano diana en el paciente hipertenso. La existencia de hemorragias y exudados, signos de hipertensión maligna, obligará a realizar un tratamiento antihipertensivo más agresivo, a la vez que se llevan a cabo exploraciones complementarias. El reciente desarrollo de técnicas de fotografía del fondo de ojo ha permitido una precisa documentación de los signos microvasculares de la retina en la HTA en estudios realizados en población general. En numerosos estudios se ha comunicado la correlación entre las lesiones retinianas microvasculares, las lesiones de órgano diana y el desarrollo de diabetes, además de constituir un predictor independiente de ictus. En esta revisión se presentan las características de las lesiones oculares en la HTA, su clasificación y su correlación con la enfermedad cardiovascular.

Abstract

The arterial hypertension is the main factor of risk for the development of cardiovascular diseases and also of vascular injuries in the retina. The ocular alterations of the HTA, they include three different and independent manifestations in the retina, optical nerve and coroidal circulation. The ophthalmologic examination made of habitual form in all hypertensive patient aid to value the gravity of the hypertension. The last guides of the European Society of Hypertension/ European Society of Cardiology (ESH/ESC) include to the fundoscopico examination within the methods to evaluate the target organ damage in the hypertensive patients. The existence of hemorrhagic and exudates it forced to make more aggressive an antihypertensive treatment, simultaneously that is made final reconnaissance. The recent development of techniques of photography of the eye bottom, it has allowed to one precise documentation of the signs microvasculars of the retina in the hypertension in studies made in general population. In numerous studies the correlation between the microvascular retinal injuries, the target organ damage and the development of diabetes has communicated, also to constitute predicting an independent predictor of ictus. We presented in this review the characteristics of the ocular injuries in the HTA appear, its classification and its correlation with the cardiovascular disease.

Palabras clave
fundoscopia, hipertensión arterial, retinopatía hipertensiva, retinopatía arterioesclerótica
Key words
fundoscopy, hypertension, hypertensive retinopathy, atherosclerotic retinopathy
This article is only available in PDF
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Correspondencia: Unidad de Hipertensión. Edificio de Medicina Comunitaria. Hospital 12 de Octubre. Avda. de Córdoba, s/n. 28041 Madrid.
Copyright © 2004. Sociedad Española de Hipertension-Liga Española para la Lucha de la Hipertensión Arterial (SEH-LELHA)