Advanced retinopathy is tightly associated with left ventricular hypertrophy in severe hypertension, but evidence linking early retinal changes to cardiac damage remains inconclusive.
Does the assessment of retinal changes correlate with cardiac remodeling (left ventricular hypertrophy) in hypertensive subjects?
While advanced retinopathy correlates with left ventricular hypertrophy in severe hypertension, the prognostic value of early retinal changes for cardiovascular risk stratification remains unproven and requires further investigation.
The clinical value of left ventricular hypertrophy (LVH), a cardinal manifestation of hypertensive organ damage, in predicting cardiovascular (CV) events, independently of blood pressure (BP) and other accompanying risk factors, has been widely documented and its role in CV stratification indisputability recognized. Although the examination of the fundus oculi provides a unique opportunity to evaluate retinal microvascular abnormalities, which may mirror systemic arteriolar damage due to high BP, no consistent evidence exists, on the prognostic value of mild degrees of retinopathy, encompassing the vast majority of uncomplicated hypertensive subjects. Personal and literature data indicate that: (1) there is a tight association between advanced retinopathy and LVH suggesting the existence of a parallel involvement of retinal tree and cardiac damage in severe untreated or poorly controlled hypertension; (2) in contrast, a firm conclusion about the relationship between early or nonspecific retinal changes (narrowing or arteriovenous crossing) and cardiac damage is not allowed by the majority of the studies; (3) future investigations, based on computer-assisted methods, are further required to document the relation between initial retinal changes with organ damage and more importantly to test their predictive value for clinical outcomes.
Cuspidi et al. (Mon,) conducted a review in Systemic hypertension. Fundus oculi examination for retinal changes was evaluated. Advanced retinopathy is tightly associated with left ventricular hypertrophy in severe hypertension, but evidence linking early retinal changes to cardiac damage remains inconclusive.