Hipertensi Retinopati : Dari Jantung Naik ke Mata
Hipertensi merupakan penyakit jantung yang paling banyak diidap, dan hingga saat ini dari data World Health Organization (WHO) tercatat sekitar 1,13 miliar orang di dunia menyandang hipertensi, artinya 1 dari 3 orang di dunia terdiagnosis hipertensi. Di Indonesia sendiri tercatat estimasi penderita hipertensi sebesar 63 juta penduduk. Hipertensi adalah jalan pembuka untuk terjadinya penyakit-penyakit degenertif lain seperti stroke, serangan jantung dan bahkan kematian. Hipertensi merupakan silent killer karena peningkatan sedikit saja dari tekanan darah dapat sangat meningkatkan potensi terjadinya resiko penyakit jantung yang berat. Hipertensi atau tekanan darah tinggi akan mempengaruhi banyak organ baik secara mikrovaskular dan makrovaskluar. Organ yang dapat dipengaruhi antara lain jantung itu sendiri, ginjal, otak, dan organ kecil lain seperti mata. Bila terjadi kerusakan organ mata terutama pada bagian retina akibat hipertensi maka disebut sebagai Hipertensi Retinopati.
Hipertensi Retinopati/Hypertensive Retinopathy sendiri pertama kali disebut oleh Marcus Gunn pada abad ke 19 ketika menangani pasien-pasien dengan hipertensi dan penyakit ginjal<!--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/HYPERTENSIONAHA.107.100230","ISSN":"0194911X","PMID":"17998472","author":[{"dropping-particle":"","family":"Schmieder","given":"Roland E.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Hypertension","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2008"]]},"page":"43-44","title":"Hypertensive retinopathy: A window to vascular remodeling in arterial hypertension","type":"article-journal","volume":"51"},"uris":["https://www.mendeley.com/documents/?uuid=f54cc9ff-65fd-4dd3-9a24-ec83ebdde8b8"]}],"mendeley":{"formattedCitation":"1","plainTextFormattedCitation":"1","previouslyFormattedCitation":"1"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}<![endif]-->1<!--[if supportFields]><![endif]-->. Saat ini Hipertensi Retinopati merupakan salah satu komplikasi hipertensi yang dapat menjadi prediktor tingkat keparahan dari suatu hipertensi itu sendiri, dan bahkan menjadi prediktor untuk terjadinya stroke akibat peningkatan darah, dikarenakan kesamaan struktur pembuluh darah pada organ mata dan otak<!--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1136/bjo.2005.072546","ISSN":"00071161","PMID":"16299149","abstract":"Hypertension is associated with cardiovascular risk and systemic target organ damage. Retinopathy is considered one of the indicators of target organ damage. This review focuses on recent studies on hypertensive retinopathy and their implications for clinical care. Early recognition of hypertensive retinopathy signs remains an important step in the risk stratification of hypertensive patients.","author":[{"dropping-particle":"","family":"Grosso","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Veglio","given":"F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Porta","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Grignolo","given":"F. M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wong","given":"T. Y.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"British Journal of Ophthalmology","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2005"]]},"page":"1646-1654","title":"Hypertensive retinopathy revisited: Some answers, more questions","type":"article-journal","volume":"89"},"uris":["https://www.mendeley.com/documents/?uuid=88197ed1-135a-4ec9-a237-46bf905e59f0"]}],"mendeley":{"formattedCitation":"2","plainTextFormattedCitation":"2","previouslyFormattedCitation":"2"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}<![endif]-->2<!--[if supportFields]><![endif]-->. Munculnya Hipertensi Retinopati dikatikan dengan peningkatan resiko stroke sebanyak 7x lipat, serangan jantung sebanyak 4x lipat, Penyakit Jantung Koroner 3x lipat dan penyakit pembuluh darah perifer sebanyak 2x lipat. Peningkatan tekanan darah akan menyebabkan kerusakan pembuluh darah mata yang bersifat progresif sehingga akan menyebabkan penurunan ketajaman penglihatan bahkan kebutaan, dapat terjadi perlahan maupun secara cepat bila tekanan darah sudah tidak terkontrol<!--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.3109/10641963.2012.663028","ISSN":"10641963","PMID":"22468968","abstract":"We aimed to determine the prevalence and risk factors of retinopathy in hypertensive outpatients. Demographic data, accompanying diseases, anthropometric measurements, and blood and urine biochemistry of 655 hypertensive patients were evaluated. Hypertensive retinopathy rate was 66.3 (grade 1, 33.6; grade 2, 32.7). Age, duration of hypertension, and systolic blood pressure levels were significant risk factors for retinopathy (P.048, P.035, and P.012, respectively). Any correlations between retinopathy and gender, body mass index, biochemistry, and associated diseases were not found. This study shows that the degree and duration of hypertension increases the incidence of retinopathy. Low-grade retinopathy seems not to be associated with other cardiovascular risks. © 2012 Informa Healthcare USA, Inc.","author":[{"dropping-particle":"","family":"Erden","given":"Sacide","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bicakci","given":"Ercan","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Clinical and Experimental Hypertension","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2012"]]},"page":"397-401","title":"Hypertensive retinopathy: Incidence, risk factors, and comorbidities","type":"article-journal","volume":"34"},"uris":["https://www.mendeley.com/documents/?uuid=12c9904c-2f50-4d5e-9d29-ac9f9a2af63a"]}],"mendeley":{"formattedCitation":"3","plainTextFormattedCitation":"3","previouslyFormattedCitation":"3"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}<![endif]-->3<!--[if supportFields]><![endif]-->. Hipertensi Retinopati seringkali tidak menunjukkan gejala, namun gejala yang dapat muncul adalah nyeri kepala, penglihatan yang menjadi bertambah kabur secara progresif, penglihatan ganda, dan pada akhirnya adalah kebutaan. Seringkali pemeriksaan mata rutin atau medical check- up menjadi awal dimana pasien mengetahui bahwa terjadinya kerusakan pada pembuluh darah pada organ matanya<!--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1136/bjo.2005.072546","ISSN":"00071161","PMID":"16299149","abstract":"Hypertension is associated with cardiovascular risk and systemic target organ damage. Retinopathy is considered one of the indicators of target organ damage. This review focuses on recent studies on hypertensive retinopathy and their implications for clinical care. Early recognition of hypertensive retinopathy signs remains an important step in the risk stratification of hypertensive patients.","author":[{"dropping-particle":"","family":"Grosso","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Veglio","given":"F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Porta","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Grignolo","given":"F. M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wong","given":"T. Y.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"British Journal of Ophthalmology","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2005"]]},"page":"1646-1654","title":"Hypertensive retinopathy revisited: Some answers, more questions","type":"article-journal","volume":"89"},"uris":["https://www.mendeley.com/documents/?uuid=88197ed1-135a-4ec9-a237-46bf905e59f0"]}],"mendeley":{"formattedCitation":"2","plainTextFormattedCitation":"2","previouslyFormattedCitation":"2"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}<![endif]-->2<!--[if supportFields]><![endif]-->.
Kewaspadaan kunci dari pencegahan terjadinya Hipertensi Retinopati. Ketika seseorang telah terdiagnosis dengan hipertensi, maka penting untuk juga mencari tahu apakah sudah ada organ lain yang mengalami komplikasi akibat hipertensi itu sendiri, termasuk pada organ mata, pembuluh darah di jantung, ginjal, dan otak. Kerusakan pada pembuluh darah mata dapat bersifat reversible atau dapat kembali ke kondisi normal pada beberapa kasus terutama pada fase awal kerusakan pembuluh darah tersebut, namun bila sudah terjadi dalam waktu yang lama sehingga terjadi perubahan struktur pembuluh darah permanen bahkan merusak retina, maka kemungkinan kembali ke kondisi normal menjadi jauh lebih kecil<!--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1136/bjo.2005.072546","ISSN":"00071161","PMID":"16299149","abstract":"Hypertension is associated with cardiovascular risk and systemic target organ damage. Retinopathy is considered one of the indicators of target organ damage. This review focuses on recent studies on hypertensive retinopathy and their implications for clinical care. Early recognition of hypertensive retinopathy signs remains an important step in the risk stratification of hypertensive patients.","author":[{"dropping-particle":"","family":"Grosso","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Veglio","given":"F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Porta","given":"M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Grignolo","given":"F. M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wong","given":"T. Y.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"British Journal of Ophthalmology","id":"ITEM-1","issue":"12","issued":{"date-parts":[["2005"]]},"page":"1646-1654","title":"Hypertensive retinopathy revisited: Some answers, more questions","type":"article-journal","volume":"89"},"uris":["https://www.mendeley.com/documents/?uuid=88197ed1-135a-4ec9-a237-46bf905e59f0"]}],"mendeley":{"formattedCitation":"2","plainTextFormattedCitation":"2","previouslyFormattedCitation":"2"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}<![endif]-->2<!--[if supportFields]><![endif]-->. Pengobatan dengan obat penurun tekanan darah, perubahan gaya hidup dan kontrol rutin ke dokter jantung dan dokter mata adalah hal yang harus dilakukan secara rutin demi mencegah kondisi yang lebih parah.<!--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.2147/OPTO.S183492","ISSN":"11792752","abstract":"Hypertensive retinopathy and choroidopathy have important short-and long-term implications on patients’ overall health and mortality. Eye care professionals should be familiar with the severity staging of these entities and be able to readily recognize and refer patients who are in need of systemic blood pressure control. This paper will review the diagnosis, staging, treatment, and long-term implications for vision and mortality of patients with hypertensive retinopathy and choroidopathy.","author":[{"dropping-particle":"","family":"Tsukikawa","given":"Mai","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stacey","given":"Andrew W.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Clinical Optometry","id":"ITEM-1","issued":{"date-parts":[["2020"]]},"page":"67-73","title":"A review of hypertensive retinopathy and chorioretinopathy","type":"article-journal","volume":"12"},"uris":["https://www.mendeley.com/documents/?uuid=f725c0fe-6d48-4a5d-8d0e-84fa92264c61"]}],"mendeley":{"formattedCitation":"4","plainTextFormattedCitation":"4","previouslyFormattedCitation":"4"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}<![endif]-->4<!--[if supportFields]><![endif]-->
Hipertensi adalah penyakit yang “membuka jalan” untuk munculnya penyakit-penyakit lain, namun seringkali kita tidak terlalu menaruh perhatian pada organ-organ lain yang mungkin mengalami kerusakan akibat hipertensi itu sendiri. Pada organ mata, seringkali tidak menunjukkan gejala namun dapat tiba-tiba mengalami kebutaan sehingga menurunkan kualitas hidup. Pemeriksaan mata segera setelah terdiagnosis hipertensi sangat penting untuk mencegah kerusakan mata yang lebih parah.
Referensi :
Schmieder RE. Hypertensive retinopathy: A window to vascular remodeling in arterial hypertension. Hypertension. 2008;51(1):43–4.
Grosso A, Veglio F, Porta M, Grignolo FM, Wong TY. Hypertensive retinopathy revisited: Some answers, more questions. Br J Ophthalmol. 2005;89(12):1646–54.
Erden S, Bicakci E. Hypertensive retinopathy: Incidence, risk factors, and comorbidities. Clin Exp Hypertens. 2012;34(6):397–401.
Tsukikawa M, Stacey AW. A review of hypertensive retinopathy and chorioretinopathy. Clin Optom. 2020;12:67–73.
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