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Changes in the optic fundi remain the simplest, most practical, and most accurate guide to prognosis in essential hypertension, with or without complications, the 113th annual convention of the AMA was told by Ray W. Gifford, Jr., MD, of the Cleveland Clinic Foundation. He explained to the San Francisco meeting that a study of 540 patients with hypertension verified validity of the Keith-Wagener-Barker classification of hypertension based solely on ophthalmoscopic findings.
The original work by Keith, et al, has been criticized, Gifford said, on grounds that (1) it included a small number of patients; (2) the followup period was short; (3) the differentiation between classification groups was not clear.
The Mayo Clinic study was undertaken to clarify and amplify the prognostic importance of ophthalmoscopic findings in hypertensive patients. Case records of 631 patients diagnosed as hypertensive at the Mayo Clinic in 1940 were used. There were 287 women and 344
Changes in Optic Fundi Are Best Guide to Prognosis in Hypertension. JAMA. 1964;188(13):31–32. doi:10.1001/jama.1964.03060390079043