Retinal Structural Changes in Systemic Arterial Hypertension: An OCT Study

Akay, Fahrettin; Gündoğan, Fatih Ç.; Yolcu, Ümit; Toyran, Sami; Tunç, Elif; Uzun, Salih

doi:10.5301/ejo.5000740

Cited by 24 publications

(22 citation statements)

References 22 publications

(24 reference statements)

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“…There have been studies reporting defects in RNFL and GCC in hypertensive patients, [15][16][17] which differ from the findings of our study. Han-Min Lee et al found a significant decrease in RNFL thickness in hypertensive retinopathy patients in a longitudinal study.…”

Section: Discussioncontrasting

confidence: 99%

“…Other studies have suggested the diagnostic ability of the GCC to detect hypertensive changes in the retina and demonstrated the correlation between inner retinal layer thickness and microvascular metrics. 12,15 We believe that further longitudinal studies are necessary to establish the association between hypertension and structural changes in RNFL and GCC.…”

Section: Discussionmentioning

confidence: 99%

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Utility of optical coherence tomography angiography in detecting vascular retinal damage caused by arterial hypertension

Pascual-Prieto

Burgos-Blasco

Sánchez-Torija

et al. 2019

European Journal of Ophthalmology

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Objective: To evaluate the potential utility of perfusion density measurements to discriminate patients with arterial hypertension by cardiovascular risk category. Methods: In this cross-sectional study, one eye per subject was evaluated (N = 73). The study cohort was divided into three groups according to the clinical criteria established by the European Guidelines for Arterial Hypertension: 26 controls, 24 patients with low cardiovascular risk, and 23 patients with very high cardiovascular risk. All patients were examined using RS-3000 Advance optical coherence tomography angiography to analyze macular and peripapillary perfusion density. Results: There were no differences among the three risk groups by sex or age. Decreased macular perfusion density was found at the level of the superficial and deep plexuses (p ⩽ 0.047). No differences were observed in peripapillary perfusion density (p = 0.18). Conclusion: Optical coherence tomography angiography can detect changes in macular perfusion density in patients with hypertension and high cardiovascular risk and might represent a supportive imaging method in the evaluation of the cardiovascular risk in hypertensive patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Utility of optical coherence tomography angiography in detecting vascular retinal damage caused by arterial hypertension

Pascual-Prieto

Burgos-Blasco

Sánchez-Torija

et al. 2019

European Journal of Ophthalmology

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“…14,15,17 In the last decade, OCT studies have also confirmed RNFL thinning as a form of hypertensive retinal damage. 30 Yu et al 31 found a close correlation between RPC volume and RNFL thickness. These reports suggest that retinal vessel rarefaction may be associated with neural damage in patients with essential hypertension.…”

Section: Discussionmentioning

confidence: 95%

Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study

Peng

Huang

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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To investigate retinal neurovascular structural changes in patients with essential hypertension. METHODS. This observational cross-sectional study consisted of 199 right eyes from 169 nondiabetic essential hypertensive patients, divided into groups as follows: group A, 113 patients with hypertensive retinopathy (HTNR); group B, 56 patients without HTNR; and a control group of 30 healthy subjects. Peripapillary retinal nerve fiber layer (RNFL), radial peripapillary segmented (RPC), ganglion cell-inner plexiform layer (GC-IPL), and superficial (SVP) and deep (DVP) vascular plexus density at the macula (6 × 6 mm 2) were measured by optical coherence tomography angiography (OCTA). RESULTS. DVP density was significantly reduced in groups A and B compared to the control group (group A DVP, P = 0.001; group B DVP P = 0.002). GC-IPL, RNFL thickness, and RPC and SVP density in group A were significantly decreased compared to the control group or group B (all P < 0.05). In hypertensive patients, GC-IPL and RNFL thickness were negatively correlated with severity of HTNR (GC-IPL, r =-0.331, P < 0.001; RNFL, r =-0.583, P < 0.001) and level of home blood pressure monitoring (HBPM)

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“…It can distinguish ten retinal layers with high resolution, and has the advantage of quantitatively evaluating the thickness of each layer. In HTN patients without retinopathy or glaucoma, thinning of the GC-IPL and peripapillary RNFL was reported 3,4,27 . In our study, there was no difference in the CMT, but the GC-IPL and RNFL thicknesses were different among the three groups, and those of HTN group 2 was thinner than the control group.…”

Section: Discussionmentioning

confidence: 99%

Peripapillary microvascular changes in patients with systemic hypertension: An optical coherence tomography angiography study

Shin

Nam

Lee

et al. 2020

Sci Rep

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the purpose of this study was to investigate changes in peripapillary microvasculature using optical coherence tomography angiography (octA) in systemic hypertension (Htn) patients. this was a crosssectional study. Based on the duration of Htn, seventy-eight Htn patients were divided into two groups. (HTN group 1: <10 years, 38 eyes; HTN group 2: ≥10 years, 40 eyes) and 90 control subjects. All subjects underwent 6 × 6 mm OCTA scan centered on the optic nerve head. We analyzed peripapillary vessel density (VD) and perfusion density (PD) in superficial capillary plexus among three groups. The average ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL) thicknesses of HTN group 2 were thinner than those of the control group (p = 0.016, and 0.035, respectively). HTN group 2 showed lower peripapillary VD and PD than the control group. However, there were no differences between HTN group 1 and the control group in OCT and peripapillary OCTA parameters. In HTN patients, the peripapillary VD, PD and GC-IPL, RNFL thicknesses correlated significantly. octA showed that the peripapillary VD and pD were lower in Htn patients with a duration ≥10 years compared with those of normal controls. peripapillary microvasculature was correlated with the RnfL and GC-IPL thicknesses. HTN duration should therefore be considered when evaluating peripapillary microvasculature using octA.Cardiovascular disease is one of the more common causes of death in developing country, and hypertension (HTN) is the most common treatable risk factor. According to a US study, approximately 68 million (31%) of patients ≥18 years of age are reported to have HTN 1 , and approximately one billion worldwide are affected by HTN 2 . With advances in medical technology, the life expectancy has been extended, and the number of patients with HTN has increased.Uncontrolled HTN can cause vascular changes in many organ systems, such as the brain, heart, kidneys, and eyes, due to elevated arterial pressure and increased peripheral resistance. Vascular changes in the eye can be directly visualized using funduscopy. Arteriolar narrowing is a hallmark of hypertensive retinopathy (HTNR), and the narrowing being characterized as either focal or diffuse. This occurs when the systemic blood pressure rises to maintain constant blood flow by autoregulation of the retinal circulation. The destruction of the inner blood-retinal barrier and vascular endothelial structure can then lead to cotton wool spots, retinal hemorrhage, and intraretinal lipid deposits.Funduscopy, optical coherence tomography (OCT), and fluorescein angiography (FA) may be helpful in the diagnosis and evaluation of retinal pathological changes in HTN. In our previous OCT study, the ganglion cell-inner plexiform layer (GC-IPL) and peripapillary retinal nerve fiber layer (RNFL) thicknesses were lower in chronic HTN and relieved HTNR patients than normal controls 3,4 , Furthermore, in previous optical coherence tomography angiography (OCTA) studies, foveal microvascular perfusion was...

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Retinal Structural Changes in Systemic Arterial Hypertension: An OCT Study

Abstract: Ganglion cell complex thickness decrease is possibly a better retinal marker for hypertensive changes with respect to RNFL and macular thickness.

Cited by 24 publications

References 22 publications

Utility of optical coherence tomography angiography in detecting vascular retinal damage caused by arterial hypertension

Utility of optical coherence tomography angiography in detecting vascular retinal damage caused by arterial hypertension

Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study

Peripapillary microvascular changes in patients with systemic hypertension: An optical coherence tomography angiography study

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