Evaluating the Clinical Utility of the DrNoon Score in Hypertensive Retinopathy and Cardiovascular Risk Stratification

Abstract

Purpose : 

We aimed to evaluate whether Dr.Noon CVD can better detect hypertensive retinopathy (HR) in patients with hypertensive emergencies compared to those with normal hypertension. Additionally, we assessed its diagnostic performance in comparison to existing cardiovascular disease (CVD) risk assessment tools and investigated whether combining Dr.Noon CVD with these traditional tools enhances diagnostic accuracy.

Methods : 

We analyzed the medical records of HR patients who consecutively visited Hanyang University Guri Hospital with hypertensive emergencies between January 2018 and January 2024. These patients were compared to an age-matched control group. HR patients were classified according to the KWB classification into normal (Group 1), low-grade HR (grade 1 and 2, Group 2), and high-grade HR (grade 3 and 4, Group 3). For CVD risk assessment, the Revised Pooled Cohort Equations 2018 (PCE) and the PREVENT score were utilized, and their performance was analyzed in relation to the HR grades. Additionally, we examined whether incorporating the Dr.Noon CVD score as an independent variable into the PCE and PREVENT models improved their ability to distinguish HR patients from normal controls.

Results : 

A total of 62 HR patients and 60 age-matched controls were included in the analysis. LDL, eGFR, SBP, and DBP levels were significantly higher in Group 2 and 3 compared to Group 1 (P=0.036, <0.001, <0.001, and 0.003, respectively). Both Dr.Noon CVD and PREVENT scores identified significantly higher risk in Group 2 and 3 compared to Group 1(P=0.007, <0.001, respectively), whereas the PCE score showed no statistical difference between the groups (P=0.582). Adjusting the PREVENT score with Dr.Noon CVD enhanced its discriminatory power for identifying HR patients as a higher-risk group, as evidenced by improvements in the adjusted R-squared value (from 0.05 to 0.14) and F-statistic (from 7.517 to 10.93).

Conclusions :

Dr.Noon CVD scores were higher in patients with more severe HR, a trend also observed with PREVENT scores. Moreover, the combination of Dr.Noon CVD scores with existing risk models demonstrated improved discriminative ability. Given the potential for underestimation of CVD risk in HR patients when using traditional risk scores alone, integrating DrNoon into conventional risk evaluation frameworks could offer clinically significant benefits and enhance assessment accuracy.

This abstract was presented at the 2025 ARVO Annual Meeting, held in Salt Lake City, Utah, May 4-8, 2025.