Evaluation of choroidal thickness via enhanced depth-imaging optical coherence tomography in patients with systemic hypertension

Abstract

Purpose:The purpose was to evaluate choroidal thickness via spectral domain optical coherence tomography (SD-OCT) and to compare the data with those of 24-h blood pressure monitoring, elastic features of the aorta, and left ventricle systolic functions, in patients with systemic hypertension.Materials and Methods:This was a case-control, cross-sectional prospective study. A total of 116 patients with systemic hypertension, and 116 healthy controls over 45 years of age, were included. Subfoveal choroidal thickness (SFCT) was measured using a Heidelberg SD-OCT platform operating in the enhanced depth imaging mode. Patients were also subjected to 24-h ambulatory blood pressure monitoring (ABPM) and standard transthoracic echocardiography (STTE). Patients were divided into dippers and nondippers using ABPM data and those with or without left ventricular hypertrophy (LVH+ and LVH-) based on STTE data. The elastic parameters of the aorta, thus aortic strain (AoS), the beta index (BI), aortic distensibility (AoD), and the left ventricular mass index (LVMI), were calculated from STTE data.Results:No significant difference in SFCT was evident between patients and controls (P ≤ 0.611). However, a significant negative correlation was evident between age and SFCT in both groups (r = −0.66/−0.56, P ≤ 0.00). No significant SFCT difference was evident between the dipper and nondipper groups (P ≤ 0.67), or the LVH (+) and LVH (-) groups (P ≤ 0.84). No significant correlation was evident between SFCT and any of AoS, BI, AoD, or LVMI.Discussion:The choroid is affected by atrophic changes associated with aging. Even in the presence of comorbid risk factors including LVH and arterial stiffness, systemic hypertension did not affect SFCT.

Choroidal thickness is associated with renal hemodynamics in essential hypertension

“…However, several evidences did not seem to confirm a direct causal role of BP on ChT structural changes, and conflicting data are observed in different studies . Gök et al did not observe significant differences in subfoveal ChT between 116 patients with arterial hypertension compared to 116 healthy controls, and Ahn et al rather demonstrated significant increase in subfoveal ChT in subjects with severe hypertension and hypertensive retinopathy, possibly due to choroidal permeability changes with subsequent interstitial fluid accumulation in the choroid layer . In line with abovementioned evidences, in our study we did not observe any independent relationship between ChT and clinic BP when we performed multivariate analyses: It is so conceivable that ChT could early reflect the vascular consequences of hypertension rather than the hypertension itself, and this could explain some inconsistencies and the heterogeneity of literature data.…”

“…Hypertension might play a leading role in determining structural modification of choroidal layer, and it might be considered as a potential determinant of choroidal thickness, causing the so‐called “hypertensive choroidopathy” as defined by Hayreh et al In a population of 160 subjects (80 hypertensives and 80 healthy controls), Akay et al demonstrated that choroidal thickness decreased in patients with systemic arterial hypertension, and overlapping findings were reported by Masís et al in a similar population, although these results could reflect only a between‐group age difference . However, several evidences did not seem to confirm a direct causal role of BP on ChT structural changes, and conflicting data are observed in different studies . Gök et al did not observe significant differences in subfoveal ChT between 116 patients with arterial hypertension compared to 116 healthy controls, and Ahn et al rather demonstrated significant increase in subfoveal ChT in subjects with severe hypertension and hypertensive retinopathy, possibly due to choroidal permeability changes with subsequent interstitial fluid accumulation in the choroid layer .…”

“…Changes in ChT have been therefore observed in subjects with diabetes, coronary artery disease, and in other conditions likewise characterized by systemic microvascular damage, including chronic kidney disease and hypertension . However, some evidence does not confirm the relationship between ChT and blood pressure, and conflicting data are observed in different studies . It is conceivable that ChT could early reflect the vascular consequences of hypertension rather than hypertension itself, so explaining the heterogeneity of literature data.…”

“…ChT and blood pressure, and conflicting data are observed in different studies. 15,16 It is conceivable that ChT could early reflect the vascular consequences of hypertension rather than hypertension itself, so explaining the heterogeneity of literature data.…”

Is choroidal thickness related with disease activity and joint damage in patient with rheumatoid arthritis

“…This technique has enabled the birth of a new scientifi c fi eld where the CT is measured to evaluate normal and pathological processes (10). Systemic disorders that affect the vascular structure such as diabetes mellitus and hypertension have been found to also affect the choroid (20,21). The research has also made it possible to more clearly understand the pathology in some ocular disorders such as central serous chorioretinopathy, degenerative myopia and age-related macular degeneration (10 p < 0.05 is signifi cant, CT -choroidal thickness, SFC -subfoveal choroidal thickness, T500 -choroidal thickness at 500 μm temporal to the fovea, T1000 -choroidal thickness at 1000 μm temporal to the fovea, T1500 -choroidal thickness at 1500 μm temporal to the fovea, N500 -choroidal thickness at 500 μm nasal to the fovea, N1000 -choroidal thickness at 1000 μm nasal to the fovea, N1500 -choroidal thickness at 1500 μm nasal to the fovea Tab.…”