Retinal Microvascular Changes in Hypertensive Patients with Different Levels of Blood Pressure Control and without Hypertensive Retinopathy

Hua, Dihao; Xu, Youming; Zhang, Xiao; He, Tao; Chen, Changzheng; Chen, Zhen; Xing, Yiqiao

doi:10.1080/02713683.2020.1775260

“…Table 1 summarizes the key characteristics of the 11 eligible studies that were included for meta-analyses. For the macula, nine studies analyzed the superficial vessel density (6,7,19,20,22,(24)(25)(26)(27), seven analyzed the deep vessel density (6,7,19,20,22,24,25), five analyzed the superficial foveal avascular zone (6,7,19,26,27), two analyzed vessel density (length) (26,27), two analyzed skeleton density (19,22), two analyzed vessel diameter index (19,22), and one analyzed fractal dimension (19). For the optic nerve head, five studies analyzed peripapillary vessel density (6,20,(23)(24)(25), two analyzed inside disc perfusion density (20,25), one analyzed vessel caliber (19), and one analyzed vessel density (length) (23).…”

Section: Supplementary Figurementioning

confidence: 99%

The Application of Optical Coherence Tomography Angiography in Systemic Hypertension: A Meta-Analysis

Tan

¹

,

Yao

²

,

Le

³

et al. 2021

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Objective: Multiple studies have compared various optical coherence tomography angiography (OCTA) parameters in participants with systemic hypertension vs. controls and have presented discordant findings. We conducted a meta-analysis to pool together data from different studies to generate an overall effect size and find out whether OCTA parameter(s) significantly differed in participants with systemic hypertension as compared to controls.Methods: We conducted a literature search through a search of electronic databases to identify studies before 19 June 2021, which compared OCTA parameters in non-diabetic participants with systemic hypertension vs. controls. If the OCTA parameter had a minimum number of 3 studies that analyzed it, the mean difference between participants with systemic hypertension and controls were analyzed using a random-effects model.Results: We identified 11 eligible studies. At the macula, 9 studies analyzed vessel density at the superficial capillary plexus (SVD), 7 analyzed vessel density at the deep capillary plexus (DVD), and 6 analyzed the area of the superficial foveal avascular zone (FAZ). Participants with systemic hypertension had significantly lower SVD (standardized mean difference [SMD], −0.50 [−0.70, −0.30], P < 0.00001, I2 = 63%), lower DVD (SMD, −0.38 [−0.64, −0.13], P = 0.004, I2 = 67%) and larger superficial FAZ (SMD, 0.32 [0.04, 0.61], P = 0.020, I2 = 77%).Conclusion: The eyes of people with systemic hypertension have robustly lower superficial and deep vascular densities at the macula when compared to control eyes. Our results suggest that OCTA can provide information about pre-clinical microvascular changes from systemic hypertension.

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“…OCTA provides microvasculature images with higher contrast and better resolution than with fluorescein angiography; furthermore, it contributes to the quantitative evaluation of retinal microvasculature [2]. Currently, OCTA images and quantitative parameters, such as vessel density (VD), have become important markers for retinal disease, and the detailed information of blood flow it provides has contributed greatly to the early detection of multiple eye diseases [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Although previous studies have reported that denoised images show lower background noise and higher image quality than that of single-scan images of the macular area [11,14], the influence of denoising using commercially available devices on the qualitative and quantitative parameters of the images of both macular and optic areas has not been investigated. The VD is considered an important marker for the early detection of multiple eye diseases; for example, the VD in the macular area can help detect retinal damage in patients with diabetes and hypertension at an early stage, and the VD in the optic area can help in the early diagnosis of glaucoma [3][4][5]. Thus, the VD in both macular and optic areas acquired from denoised images needs to be verified as credible data before its application in the clinical setting.…”

Section: Introductionmentioning

confidence: 99%

Enhanced Visualization of Retinal Microvasculature via Deep Learning on OCTA Image Quality

Xu

¹

,

Su

²

,

Hua

³

et al. 2021

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Purpose. To investigate the impact of denoising on the qualitative and quantitative parameters of optical coherence tomography angiography (OCTA) images of the optic nerve and macular area. Methods. OCTA images of the optic nerve and macular area were obtained using a Canon-HS100 OCT device for 48 participants (48 eyes). Multiple image averaging (MIA) and denoising techniques were used to improve the quality of the OCTA images. The peak signal-to-noise ratio (PSNR) as an image quality parameter and vessel density (VD) as a quantitative parameter were obtained from single-scan, MIA, and denoised OCTA images. The parameters were compared, and the correlation was analyzed between different imaging protocols. Results. In the optic nerve area, there were significant differences in the PSNR and VD in all measured regions between the three groups ( P < 0.0001 ). The PSNR of the denoised group was significantly higher than that of the other two groups ( P < 0.0001 ). The VD in the denoised group was significantly lower than that in the single-scan group in all measured regions ( P < 0.0001 ). In the macular area, there were significant differences in the PSNR and VD in all measured regions among the three groups. The PSNR of the denoised group was significantly higher than that of the other two groups ( P < 0.0001 ). The VD in the denoised group was significantly lower than that in the single-scan group in all measured regions. The VD around the optic nerve in the denoised group was correlated with that in the single-scan group ( R = 0.9403 , P < 0.0001 ), but the VD in the MIA group was not correlated with that in the single-scan group ( R = 0.2505 , P = 0.2076 ). The VD around the fovea in the denoised and MIA images was correlated with that in the single-scan group ( R = 0.7377 , P < 0.0001 ; R = 0.7005 , P = 0.0004 , respectively). Conclusion. Denoising could provide an easy and quick way to improve image quality parameters, such as PSNR. It shows great potential in improving the sensitivity of OCTA images as retinal disease markers.

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“…ОКТ-А позволяет изучить площадь фовеолярной аваскулярной зоны (ФАЗ), плотность сосудов поверхностного сосудистого сплетения сетчатки (ПСПС) и плотность сосудов глубокого сплетения сетчатки (ПСГС), а также плотность сосудов в слое хориокапилляров (ПСХ). Авторы, изучающие плотность сосудов сетчатки при ГБ, получили противоречивые результаты: увеличение и уменьшение ФАЗ, повышение или снижение ПСПС сетчатки, повышение или снижение ПСГС сетчатки и слоя хориокапилляров [3,11,[16][17][18][19][20][21]. С учетом того, что данные по изучению плотности сосудов сетчатки у пациентов с ГБ, особенно с ГБ и ИБС, противоречивы, и предпринято данное исследование.…”

Section: Introductionunclassified

Ophthalmological monitoring in patients with hypertension and coronary heart disease

Lk¹,

Vorobyeva²,

Dgebuadze³

et al. 2021

Russian Journal of Clinical Ophthalmology

3

0

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Aim: to study ophthalmological clinical functional parameters in patients with hypertension and coronary heart disease (CHD) with coronary artery stenosis. Patients and Methods: 30 patients (58 eyes) with hypertension and CHD with coronary artery stenosis (group A) and 30 healthy controls (60 eyes, group B) were examined. Best-corrected visual acuity (BCVA), macular sensitivity (MS) assessed by MAIA microperimetry, central macular thickness (CMT), foveal avascular zone (FAZ) area, vessel density of superficial capillary plexus (SCP VD) and deep capillary plexus (DCP VD) and choriocapillaris measured by optical coherence tomography angiography (OCTA) were evaluated. Results: FAZ area was 0.42±0.03 mm2 in group A and 0.28±0.03 mm2 in group B (p<0.05). SCP VD was 11.4±3.1% in group A and 25.4±2.5% in group B (p<0.05). DCP VD was 22.3±1.1% in group A and 39.2±3.5% in group B (p<0.05). Choriocapillaris VD was 51.2±1.1% in group A and 63.1±1.2% in group B (p<0.05). Correlations between ocular parameters and ejection fraction (EF) were revealed (BCVA: r=0.61, p<0.05; MS: r=0.68, p<0.05; CMT: r=-0.72, p<0.05; FAZ: r=-0.73, p<0.05; SCP VD: r=0.82, p<0.05; DCP VD: r=0.81, p<0.05; choriocapillaris VD: r=0.76, p<0.05). Conclusions: in patients with hypertension and CHD with coronary artery stenosis, significant (p<0.05) reduction in BCVA, MS, SCP VD, DCP VD, and choriocapillaris VD and increase in CMT and FAZ area were detected compared to healthy individuals. Additionally, strong correlations between ocular parameters (FAZ, SCP VD, DCP VD, and choriocapillaris VD) and EF (p<0.05) were identified. OCTA may be recommended to monitor fundus vessels in hypertension and CHD as an effective noninvasive valuable diagnostic tool to verify hypertension and CHD. Keywords: hypertension, coronary heart disease, coronary artery stenosis, hypertensive retinopathy, foveal avascular zone, vessel density, optical coherence tomography angiography. For citation: Moshetova L.K., Vorobyeva I.V., Dgebuadze A. et al. Ophthalmological monitoring in patients with hypertension and coronary heart disease. Russian Journal of Clinical Ophthalmology. 2021;21(2):51–57. DOI: 10.32364/2311-7729-2021-21-2-51-57.

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Retinal Microvascular Changes in Hypertensive Patients with Different Levels of Blood Pressure Control and without Hypertensive Retinopathy

Cited by 27 publications

References 36 publications

The Application of Optical Coherence Tomography Angiography in Systemic Hypertension: A Meta-Analysis

The Application of Optical Coherence Tomography Angiography in Systemic Hypertension: A Meta-Analysis

Enhanced Visualization of Retinal Microvasculature via Deep Learning on OCTA Image Quality

Ophthalmological monitoring in patients with hypertension and coronary heart disease

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