The advantage of the simplified method over the KWB system in correlating retinal microvascular signs to incident cardiovascular risk supports its adoption in clinical practice. However, the difficulty in separating Groups 1 and 2 of this classification has lead to numerous modifications that make comparisons from one study to another difficult. Previous article in issue; Next article in issue; Key Words.  |  Blog … From the gradable retinal photos obtained by 200 eyes of 107 consecutive patients (age: 54 ± 13 years, 51% men, 79% hypertensive patients) and after adjustments for confounders, the intraobserver and interobserver level of agreement was as following: KWB 88/64% and Mitchell-Wong 91/71%, respectively; exclusively in younger, not older, individuals aortic stiffness, carotid hypertrophy, but not plaques, were significantly associated with both systems, independently from confounders; no differences regarding target organ damage were found between stages 1 and 2 of KWB. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: The Keith–Wagener–Barker and Mitchell–Wong grading systems for hypertensive retinopathy: association with target organ damage in individuals below 55 years. Another classification schema is the Keith-Wagner-Barker classification. Intraobserver agreement was assessed through a repeat grading after 6 months. 2019 Aug;257(8):1687-1698. doi: 10.1007/s00417-019-04358-3. Background: J Hypertens. Clin Exp Hypertens. Get the latest public health information from CDC: NIH Retinal vessels respond to elevations of systemic blood pressure by generalized arteriolar constriction. Peng Q, Hu Y, Huang M, Wu Y, Zhong P, Dong X, Wu Q, Liu B, Li C, Xie J, Kuang Y, Yu D, Yu H, Yang X. Some features of the site may not work correctly. (HCA)LL.B., PGDHR, FICFMT, M.B.B.S., M.Ch.Fellow - Endovascular Neurosurgery, Docplexus Online Services Pvt. If the blood pressure is controlled, or slow rising, or if arteriolar sclerosis is present in the retinal arteries, then a picture of arteriolar irregularity will be noted and, depending upon the ability of the retinal vessels to contract, segmental constriction will be seen. van den Born BJ, Schlingemann RO, Hoekstra JB, van Montfrans GA. Ned Tijdschr Geneeskd. In 1898 Marcus Gunn described the changes in retinal vessels noted with hypertension. By continuing you agree to the use of cookies. In prognosticating for survival, the best method available is the Keith-Wagener-Barker classification.

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