title: Retinal vascular changes in hypertensive patients in Ibadan, Sub-Saharan Africa.
abstract: BACKGROUND
  Earlier studies in Nigeria reported the rarity of retinal vascular changes in hypertensives. The aim of this study was to describe the various retinal vascular changes in the hypertensive patients of Nigeria.
  
  
  METHODS
  Nine hundred and three hypertensive patients were studied. This study was approved by the ethical and research committee of the University of Ibadan and University College Hospital, Ibadan, Nigeria. Blood pressure and anthropometric measurements were measured. Cardiac echocardiography was performed on 156 patients. All patients had dilated fundoscopy and fundus photography using the Kowa portable fundus camera and an Apple iPhone with 20 D lens. Statistical analysis was done with Statistical Packages for the Social Sciences (Version 21).
  
  
  RESULTS
  The mean age of patients was 57 years with a male:female ratio of 1. No retinopathy was found in 556 (61.5%) patients. In all, 175 (19.4%) patients had features of hypertensive retinopathy. Retinal vascular occlusion was a significant finding in 121 patients (13.4%), of which branch retinal vein occlusion, 43 (4.7%), and central retinal vein occlusion, 30 (3.3%), were the most prominent ones in cases. Hemicentral retinal vein occlusion, 26 (2.9%), and central retinal artery occlusion, 17 (1.9%), were significant presentations. Other findings included nonarteritic anterior ischemic optic neuropathy in five (0.6%) patients, hypertensive choroidopathy in seven (0.8%) patients, and hemorrhagic choroidal detachment in five (0.6%) patients. Left ventricular (LV) geometry was abnormal in 85 (55.5%) patients. Concentric remodeling, eccentric hypertrophy, and concentric hypertrophy were observed in 43 (27.6%), 26 (17.2%), and 15 (9.7%) patients, respectively. LV hypertrophy was found in 42 (27%) patients, while 60 (39%) patients had increased relative wall thickness. In this study, bivariate analysis showed a correlation between LV relative wall thickness and severity of retinopathy in both eyes (Spearman's coefficient 0.6; P=0.0004).
  
  
  CONCLUSIONS
  Hypertensive retinal vascular changes are not rare in Ibadan.
authors.affiliation: Department of Ophthalmology.
authors.forename: Sunday Tunji
authors.initials: ST
authors.lastname: Oluleye
authors.affiliation: Department of Ophthalmology.
authors.forename: Bolutife Ayokunu
authors.initials: BA
authors.lastname: Olusanya
authors.affiliation: Department of Medicine, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
authors.forename: Abiodun Moshood
authors.initials: AM
authors.lastname: Adeoye
keywords: Ibadan; hypertensive retinopathy; left ventricular wall thickness; retinal vascular changes; retinal vascular occlusion