Key result
Fundus examination by a non-specialty trained veterinarian showed 72% reliability in cats with vision and 100% in cats without vision for detecting abnormalities compared to an ophthalmologist.
Why the study?
Fundoscopy helps corroborate acute clinical relevance of high blood pressure, but not every cat with elevated blood pressure can be examined by an ophthalmologist.
Does indirect ophthalmoscopy performed by a non-specialty trained veterinarian reliably detect fundus abnormalities compared to a veterinary ophthalmologist in cats with suspected systemic hypertension?
Cross-Sectional (n=33)
Does indirect ophthalmoscopy performed by a non-specialty trained veterinarian reliably detect fundus abnormalities compared to a veterinary ophthalmologist in cats with suspected systemic hypertension?
Fundus examination by a non-specialty trained veterinarian has reasonably high reliability for detecting ocular target organ damage in cats with suspected systemic hypertension.
Answers are grounded in this paper and cite their sources.
May support non-specialist fundus screening in blind cats with suspected hypertension; leaves open reliability and validation in sighted cats.
OBJECTIVES: Systemic hypertension (SHT) causes severe target organ damage (TOD) and blood pressure (BP) measurement should be routine in at-risk populations. Fundoscopy is a tool to corroborate acute clinical relevance of high BP results and to decide on immediate therapy. Not every cat with a high BP result can be examined by an ophthalmologist. The study objective was to determine the reliability of fundoscopy in cats with SHT performed by a veterinarian without ophthalmology specialty training. METHODS: Cats with suspicion of hypertensive TOD or belonging to an at-risk population for SHT with a first measurement of elevated BP >160 mmHg were enrolled. Indirect ophthalmoscopy was performed by a recent graduate veterinarian followed by a veterinary ophthalmologist. Confirmation of SHT was based on two additional sets of systolic BP measurements >160 mmHg by Doppler sphygmomanometry. RESULTS: Thirty-three cats were included. SHT was confirmed in 27 cats. SHT was detected on routine examinations in 12/27 cats; fundoscopic lesions were observed in 9/12 by the non-trained veterinarian and in 11/12 by an ophthalmologist. Nine of 27 cats were neurological patients; fundoscopic lesions were detected in 4/9 by the non-trained veterinarian and in 7/9 by an ophthalmologist. Six of 27 cats were presented for acute blindness; fundus lesions were detected in all six cats by the non-trained veterinarian and ophthalmologist. SHT was not confirmed and fundoscopic lesions were not detected by either examiner in 6/33 cats. Compared with a veterinary ophthalmologist, reliability of detecting fundus abnormalities by the non-trained veterinarian was 72% (13/18) for cats with, and 100% (6/6) for cats without, vision. CONCLUSIONS AND RELEVANCE: Fundus examination by a non-specialty trained veterinarian has reasonably high reliability for the detection of ocular TOD. Private practice veterinarians are encouraged to perform an initial fundic examination in suspected hypertensive cats.
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Moretto et al. (2021) conducted a cross-sectional in Systemic hypertension (n=33). Fundoscopy by a non-specialty trained veterinarian vs. Fundoscopy by a veterinary ophthalmologist was evaluated on Reliability of detecting fundus abnormalities. Fundus examination by a non-specialty trained veterinarian showed 72% reliability in cats with vision and 100% in cats without vision for detecting abnormalities compared to an ophthalmologist.
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