Relationship of Quantitative Retinal Capillary Network and Myocardial Remodeling in Systemic Hypertension

Abstract

Background This study examined the associations between quantitative optical coherence tomography angiography (OCTA) parameters and myocardial abnormalities as documented on cardiovascular magnetic resonance imaging in patients with systemic hypertension. Methods and Results We conducted a cross‐sectional study of 118 adults with hypertension (197 eyes). Patients underwent cardiovascular magnetic resonance imaging and OCTA (PLEX Elite 9000, Carl Zeiss Meditec). Associations between OCTA parameters (superficial and deep retinal capillary density) and adverse cardiac remodeling (left ventricular mass, remodeling index, interstitial fibrosis, global longitudinal strain, and presence of left ventricular hypertrophy) were studied using multivariable linear regression analysis with generalized estimating equations. Of the 118 patients with hypertension enrolled (65% men; median [interquartile range] age, 59 [13] years), 29% had left ventricular hypertrophy. After adjusting for age, sex, systolic blood pressure, diabetes, and signal strength of OCTA scans, patients with lower superficial capillary density had significantly higher left ventricular mass (β=−0.150; 95% CI, −0.290 to −0.010), higher interstitial volume (β=−0.270; 95% CI, −0.535 to −0.0015), and worse global longitudinal strain (β=−0.109; 95% CI, −0.187 to −0.032). Lower superficial capillary density was found in patients with hypertension with replacement fibrosis versus no replacement fibrosis (16.53±0.64 mm ‐1 versus 16.96±0.64 mm ‐1 ; P =0.003). Conclusions We showed significant correlations between retinal capillary density and adverse cardiac remodeling markers in patients with hypertension, supporting the notion that the OCTA could provide a non‐invasive index of microcirculation alteration for vascular risk stratification in people with hypertension.

Swept-source optical coherence tomography angiography automatic analysis of microvascular changes secondary to systemic hypertension

“…By using built-in automatic OCTA softwares, OCTA can easily and quickly measure retinal and choroidal microvascular parameters, including VD and FAZ area. 10,[16][17][18][19][20] Moreover, with the recent introduction of SS-OCTA, the visualization of the choroid has been improved notably. The longer center wavelength of this device is less scattered by the RPE and less prone to low signal in the CC.…”

“…In these reports, quantitative parameters of OCTA were measured using image processing softwares that require a considerable amount of time. 7,9,10…”

“…In these reports, quantitative parameters of OCTA were measured using image processing softwares that require a considerable amount of time. 7,9,10 The aim of our study is to report SS-OCTA quantitative parameters of retinal and choroidal microvascularization in subjects with HTN using a built-in software.…”

The association between retinal microvasculature derived from optical coherence tomography angiography and systemic factors in type 2 diabetics

“…Yeung et al ( 25 ) reported that patients with CKD (eGFR<60 mL/min/1.73m 2 ) had lower parafoveal SCP-VD compared to those of control group ( p < 0.001), with eGFR strongly related with SCP-VD in multivariate-adjusted models. Observational cross-sectional studies ( 26 , 27 ) aimed at investigating the relationship between systemic risk factors and OCTA parameters in patients with systemic hypertension found a significant correlation between eGFR and retinal capillary density after adjusting for age, sex, and blood pressure, suggesting impaired renal function could be one of important risk factors in retinal microvascular alterations. Similarly, Zhuang et al ( 28 ) demonstrated that decreased SCP-VD was independently correlated with lower eGFR among T2DM patients, while other investigators ( 29 ) found a significant relationship between lower SCP-VD, SCP-PD, and higher UACR in T2DM patients after controlling for systemic and ocular parameters.…”

Retinal and Choroidal Thinning—A Predictor of Coronary Artery Occlusion?

“…The relations between various systemic diseases, including heart, and changes in ocular microvasculature has been a focus of studies in recent years [ 2 , 3 , 4 ]. Alternations in the thickness of the retina and its layers as well as changes in retinal microvasculature parameters was shown to be related to cardiovascular health [ 5 , 6 , 7 ]. Poplin et al, in 2018, developed an algorithm based on about 300,000 images of retinal fundus.…”