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Prevalence and Severity of Hypertensive Retinopathy in Children

Division of Nephrology, Department of Pediatrics; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montral, Quebec, Canada, beth.foster{at}muhc.mcgill.ca

Huma Ali

Faculty of Medicine, McGill University, Montral, Quebec, Canada

Silvia Mamber, MD

Division of Nephrology, McGill University, Montral, Quebec, Canada

Robert C. Polomeno, MD

Department of Ophthalmology, McGill University, Montral, Quebec, Canada

Andrew S. Mackie, MD, SM

Division of Cardiology, McGill University, Montral, Quebec, Canada

The National High Blood Pressure Education Program (NHBPEP) report recommends a retinal exam seeking evidence of target organ damage in hypertensive children. This study aimed to determine the prevalence and severity of hypertensive retinopathy among hypertensive children, evaluated by pediatric ophthalmologists in the "real world" clinical setting using direct ophthalmoscopy. The authors retrospectively reviewed the medical records of the 83 children diagnosed with hypertension by a pediatric nephrologist between 1999 and 2006. Of the 35 children examined by an ophthalmologist within 12 months of the diagnosis of hypertension, only 3 (8.6%; 95% CI, 1.8%-23.1%) were diagnosed with hypertensive retinopathy. Despite the fact that those selected for retinal examination were likely at higher risk for retinopathy, the prevalence of retinopathy was low, and only mild abnormalities were detected. Given the lack of evidence linking mild retinal abnormalities with adverse outcomes, the NHBPEP recommendation for retinal examinations in hypertensive children should be reconsidered.

Key Words: blood pressure • target organ damage • child • hypertension

This version was published on November 1, 2009

Clinical Pediatrics, Vol. 48, No. 9, 926-930 (2009)
DOI: 10.1177/0009922809339385


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