• Atencion primaria · Jun 2020

    [Reliability of retinography for the detection of hypertensive retinopathy in Primary Care].

    • Josep M Manresa, Rosa Forés, Xosé Vázquez, M Teresa Alzamora, Antonio Heras, Pilar Delgado, and Pere Torán.
    • Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Mataró, España; Departament d'Infermeria, Universitat Autònoma de Barcelona, Cerdanyola del Vallès (Barcelona), España; Centre d'Atenció Primària Riu Nord-Riu Sud, Santa Coloma de Gramenet, Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Barcelona, España.
    • Aten Primaria. 2020 Jun 1; 52 (6): 410-417.

    ObjectiveHigh blood pressure is one of the most prevalent diseases in general adult population. Its importance lies in the complications it causes in target organs such as kidney, heart, brain and eye. The aim of this work is to evaluate the agreement in the evaluation and interpretation of retinographies of hypertensive patients by family doctors and ophthalmologists.Material And MethodsThis is a multicentric cross-sectional study in which 976 hypertensive patients from 50 to 70 years old were involved. They were participants of the «Investigating Silent Strokes in Hypertensives: a Magnetic Resonance Imaging Study» (ISSYS project) carried out in primary care centers of Barcelona and who agreed to undergo retinography. Six family physicians and 2 ophthalmologists evaluated the presence of retinal lesions through the Keith-Wagener-Barker criteria.ResultsThe inter/intra-observer Kappa concordance of the evaluations was analyzed. The evaluation of the retinographies under the usual conditions of clinical practice obtained a high subjective component with slight and fair intra-observer concordance values in the Keith-Wagener-Barker criteria. Only the assessment of the microaneurysms showed a moderate concordance and the ratio artery/vein was the worst concordant.ConclusionsThe evaluation of the retinographies in habitual conditions of clinical practice has a high subjective component that is reflected in slight and fair inter-intraobserver concordance values. The use of objective reading systems in the assessment of retinography in hypertensive patients would be useful.Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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