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Hypertensive retinopathy: comparing the Keith-Wagener-Barker to a simplified classification.

Publication ,  Journal Article
Downie, LE; Hodgson, LAB; Dsylva, C; McIntosh, RL; Rogers, SL; Connell, P; Wong, TY
Published in: J Hypertens
May 2013

PURPOSE: This study assessed the interobserver and intraobserver grading reliability of the Keith-Wagener-Barker (KWB) system to the proposed Mitchell-Wong 'simplified' three-grade classification for hypertensive retinopathy. METHODS: Digital retinal images of normal and hypertensive human fundii (n = 50 per group) were randomly graded by an optometrist and an ophthalmologist using the two systems. Interobserver agreement was compared to a 'gold standard' research grader. Intraobserver agreement was assessed through a repeat grading after 6 months. Cohen's kappa coefficients were used to assess the degree of agreement. RESULTS: Both clinicians demonstrated a good level of agreement with the KWB and simplified classification compared with a 'gold standard' grader; there was no significant difference in the level of agreement for either of the two classification methods for either observer. The simplified classification was found to be equally as efficacious as the KWB system with respect to interobserver and intraobserver agreement for both practitioners. CONCLUSION: These findings indicate that the simplified classification of hypertensive retinopathy is both reliable and repeatable. 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.

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Published In

J Hypertens

DOI

EISSN

1473-5598

Publication Date

May 2013

Volume

31

Issue

5

Start / End Page

960 / 965

Location

Netherlands

Related Subject Headings

  • Hypertensive Retinopathy
  • Humans
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1116 Medical Physiology
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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Downie, L. E., Hodgson, L. A. B., Dsylva, C., McIntosh, R. L., Rogers, S. L., Connell, P., & Wong, T. Y. (2013). Hypertensive retinopathy: comparing the Keith-Wagener-Barker to a simplified classification. J Hypertens, 31(5), 960–965. https://doi.org/10.1097/HJH.0b013e32835efea3
Downie, Laura E., Lauren A. B. Hodgson, Carly Dsylva, Rachel L. McIntosh, Sophie L. Rogers, Paul Connell, and Tien Y. Wong. “Hypertensive retinopathy: comparing the Keith-Wagener-Barker to a simplified classification.J Hypertens 31, no. 5 (May 2013): 960–65. https://doi.org/10.1097/HJH.0b013e32835efea3.
Downie LE, Hodgson LAB, Dsylva C, McIntosh RL, Rogers SL, Connell P, et al. Hypertensive retinopathy: comparing the Keith-Wagener-Barker to a simplified classification. J Hypertens. 2013 May;31(5):960–5.
Downie, Laura E., et al. “Hypertensive retinopathy: comparing the Keith-Wagener-Barker to a simplified classification.J Hypertens, vol. 31, no. 5, May 2013, pp. 960–65. Pubmed, doi:10.1097/HJH.0b013e32835efea3.
Downie LE, Hodgson LAB, Dsylva C, McIntosh RL, Rogers SL, Connell P, Wong TY. Hypertensive retinopathy: comparing the Keith-Wagener-Barker to a simplified classification. J Hypertens. 2013 May;31(5):960–965.

Published In

J Hypertens

DOI

EISSN

1473-5598

Publication Date

May 2013

Volume

31

Issue

5

Start / End Page

960 / 965

Location

Netherlands

Related Subject Headings

  • Hypertensive Retinopathy
  • Humans
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1116 Medical Physiology
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology