Factors associated with changes in retinal microcirculation after antihypertensive treatment

Abstract

We report the results of hypertensive treatment over retinal arteriole narrowing in a group of 189 hypertensive patients during a 6-month treatment programme for hypertension. These patients were included in an observational study under clinical practice conditions and analysed using digital photographs of the eye fundus with a previously described semiautomatic snakes method. We analysed the relation between blood pressure control and retinal microcirculation changes during the treatment. We included 189 hypertensive patients; 74.0% of them had BP under control after 6 months of follow-up. The arteriovenous ratio (AVR), measured as the relation between the average retinal arteriole and venous diameter, significantly increased after 6 months of follow-up in both eyes (right eye AVR: 0.769±0.065 vs. 0.799±0.066 (P<0.0001); left eye AVR: 0.770±0.065 vs. 0.796±0.071 (P<0.0001)). AVR changes were caused by increases in arteriole diameter. No linear correlation was found between blood pressure-lowering levels and AVR increase, suggesting that other factors could be involved in the regression of retinal changes. We conclude that in our group of hypertensive patients it was possible to increase the retinal arteriole diameter, expressing an improvement in retinal microcirculation after 6 months of adequate BP control. Although there is an inverse tendency between blood pressure and arteriovenous ratio changes, we could not find a linear correlation between these changes.

Comparisons of microvascular and macrovascular changes in aldosteronism-related hypertension and essential hypertension

“…It is worth noting that AVR appears to be an independent risk factor for stroke. AVR may have a further useful application in relation to the observation that the AVR parameter may increase in response to antihypertensive treatment by modifying the retinal arteriole diameter, expressing an improvement in retinal microcirculation 53 . In this context, AVR may be a useful indicator as a therapeutic target capable of reflecting the effectiveness of antihypertensive drug treatment in controlling high BP values, PA included.…”

Assessing Microvascular Function in Humans from a Chronic Disease Perspective

“…83 In addition, 6-12 months of BP treatment resulted in wider arteriolar diameters. 84,85 Finally, lifestyle interventions may also be a treatment option to normalize microvascular diameters. 86 Data on retinal microvascular diameters and renal function or disease are less consistent.…”

A Deep Learning Architecture for Vascular Area Measurement in Fundus Images

“…The architecture showed that the retinal venular area is larger than the retinal arteriolar area in fundus images, as expected based on previous findings obtained from vascular caliber measurements. 32,33 In addition, we elucidated as a novel finding that the correlation between the retinal arteriolar area and BP was stronger than that between manually evaluated AVR and BP.…”