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Prevalence and severity of hypertensive retinopathy in children

Bethany J Foster1, Huma Ali, Silvia Mamber

  • 1Division of Nephrology, Department of Pediatrics, McGill University, Montral, Quebec, Canada. beth.foster@muhc.mcgill.ca

Clinical Pediatrics
|July 3, 2009
PubMed

Insights

Retinal exams in hypertensive children show low prevalence of retinopathy, with only mild abnormalities found. Current recommendations for routine retinal screening in this population may need reconsideration due to limited evidence of harm.

Area of Science:

  • Ophthalmology
  • Pediatric Nephrology
  • Public Health

Background:

  • The National High Blood Pressure Education Program (NHBPEP) recommends retinal examinations for hypertensive children to detect target organ damage.
  • Hypertensive retinopathy is a potential complication of high blood pressure in pediatric populations.

Purpose of the Study:

  • To determine the prevalence and severity of hypertensive retinopathy in children diagnosed with hypertension.
  • To evaluate the utility of routine retinal examinations in this demographic within a real-world clinical setting.

Main Methods:

  • Retrospective review of medical records of 83 children diagnosed with hypertension.
  • Analysis of ophthalmological examinations performed within 12 months of hypertension diagnosis in 35 children.
  • Direct ophthalmoscopy by pediatric ophthalmologists.

Main Results:

  • Only 3 out of 35 (8.6%) children examined had hypertensive retinopathy.
  • The retinopathy detected was generally mild.
  • Prevalence was low even in children selected for examination, likely representing a higher-risk group.

Conclusions:

  • The prevalence of hypertensive retinopathy in children is low.
  • Mild retinal abnormalities in hypertensive children lack strong evidence of adverse outcomes.
  • Reconsideration of NHBPEP recommendations for routine retinal examinations in hypertensive children is warranted.

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