Author/Editor		Petek-Šter, Marija; Švab, Igor; Hawlina, Marko
Title		Pregled očesnega ozadja kot možna metoda za oceno srčno-žilne ogroženosti
Translated title		The eye-ground examination as a possible method for cardiovascular risk assessment
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 74, št. 12
Publication year		2005
Volume		str. 761-5
Language		slo
Abstract		Background. The aim of this research was to find out, whether arteriolar changes, found during an eye examination, predict high risk of a cardiovascular event, independently from the cardiovascular risk factors using the coronary risk tables. Methods. The cross-sectional study involved 100 patients: 50 consecutive patients with arterial hypertension and 50 consecutive attenders without arterial hypertension. Excluding criteria were: age younger than 40 and older than 70, diabetes, cataract or usage of eye-drops for lowering high ocular pressure. Retinal examination was performed using the method of direct opthalmoscopy at dilated pupil. The considered retinal changes were: generalized arteriolar narrowing, focal arteriolar narrowing, arteriovenous nicking and widened ligh reflex, but we were also looking for the presence of retinopathy (hemorrhages, exudates, optic discswelling). The cardiovascular risk was calculated using tables of coronary risk. A risk of 20% or more in the next 10 years was considered as high risk for a cardiovascular event. Results. The mean age of participant was 53.5 years (SD 7.6 years). 17 (17%) participants had high coronary risk (i.e. equal or higher than 20%, according to the tables of coronary risk). retinal changes were present in 54 (54%) participants, and were more common in the group of hypertensive patients (p=0.001). In the univariate analysis all four types of microvascular were associated with at least 20% coronary risk, but in multivariate analysis two types of retinal changes, arteriovenous nicking (OR=9.136, 95% CI from 1.696 to 49.216) and focal arteriolar narrowing (OR= 5.885, 95% CI from 1.204 to 28.758), were associated with high cardiovascular risk.Conclusions. Microvascular changes are common among middle aged people attending general practice. (Abstract trunacted at 2000 characters)
Summary		Izhodišča. Namen raziskave je bil ugotoviti, ali pri pregledu ozadja ugotovljene spremembe arteriol neodvisno od ostalih dejavnikov tveganja tudi napovedujejo veliko ogroženost za srčno-žilni dogodek. Metode. V presečni raziskavi je sodelovalo 100 preiskovancev: 50 zaporednih obiskovalcev z arterijsko hipertenzijo in 50 zaporednih obiskovalcev ambulante z normalnim krvnim tlakom. Izključitvena merila so bila: starost pod 40 let in nad 70 let, prisotnost sladkorne bolezni ali motenj v očesnih medijih ter uporaba kapljic za znižanje visokega očesnega tlaka. Očesno ozadje smo pregledovali po metodi direktne oftalmoskopije pri široki zenici. Opazovane spremembe na očesnem ozadju so bile: generalizirano ozke arteriole, fokalno zožene arteriole, kržiščni znaki in poudarjen svetlobni refleks, ugotavljali pa smo tudi morebitno prisotnost retinopatije (krvavitve, eksudati, edem papile vidnega živca). Srčno-žilno tveganje smo ocenjevali z uporabo tabel koronarne ogroženosti. Tveganje, enako ali večje od 20%, v naslednjih 10 letih smo opredelili kot veliko tveganje za srčno-žilni dogodek. Rezultati. Povprečna starost preiskovancev je bila 53,5 leta (SD 7,6 leta). V skupino velike ogroženosti (ogroženost na osnovi tabel koronarne ogroženosti enaka ali večja od 20%) je sodilo 17 (17%) preiskovancev. Kakršne koli spremembe na očesnem ozadju so bile prisotne pri 54 (54%) preiskovancih, pogosteje so bile prisotne pri bolnikih z arterijsko hipertenzijo (p=0,001). V univariatni analizi so bile vse štiri opazovane spremembe na žilah očesnega ozadja povezane s koronarno ogroženostjo, enako ali večjo od 20%, v multivariatni analizi pa sta se prisotnost kržiščnih znakov (razmerje obetov 9,14 95-odstotni interval zaupanja od 1,70 do 49,22) in fokalno zoženje arteriol (razmerje obetov 5,89, 95-odstotni interval zaupanja od 1,20 do 28,76) izkazali za spremembi, ki napovedujeta veliko ogroženost za srčno-žilni dogodek. (Izvleček prekinjen pri 2000 znakih).
Descriptors		FUNDUS OCULI HYPERTENSION OPHTHALMOSCOPY RETINAL VESSELS CORONARY DISEASE AMBULATORY CARE RISK ASSESSMENT