Systemic hypertension associated retinal microvascular changes can be detected with optical coherence tomography angiography

Sun, Christopher Ziyu; Ladores, Carlo S.; Hong, Jimmy; Nguyen, Duc Quang; Chua, Jacqueline; Ting, Daniel Sw; Schmetterer, Leopold; Wong, Tien Yin; Cheng, Ching-Yu; Tan, Anna

doi:10.1038/s41598-020-66736-w

Cited by 53 publications

(53 citation statements)

References 57 publications

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“…Overall, the alterations in CFD as a result of systemic hypertension follows www.nature.com/scientificreports/ a distinct pattern and is dependent on the systolic BP. In persons with systemic hypertension, particularly those with uncontrolled BP and poorer renal function, alterations occurred in both the choriocapillaris (flow deficits were lower in absolute count and larger in average size) and retinal microvasculature (sparser vessel density) 13,14 . Hence, this finding also supports the beneficial role of strict BP control to prevent microvascular damage.…”

Section: Discussionmentioning

confidence: 99%

Choriocapillaris microvasculature dysfunction in systemic hypertension

Chua

Tan

et al. 2021

Sci Rep

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We examined the choriocapillaris microvasculature using a non-invasive swept-source optical coherence tomography angiography (SS-OCTA) in 41 healthy controls and 71 hypertensive patients and determined possible correlations with BP and renal parameters. BP levels, serum creatinine and urine microalbumin/creatinine ratio (MCR) specimens were collected. The estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. The main outcome was choriocapillaris flow deficits (CFD) metrics (density, size and numbers). The CFD occupied a larger area and were fewer in number in the hypertensive patients with poor BP control (407 ± 10 µm2; 3260 ± 61) compared to the hypertensives with good BP control (369 ± 5 µm2; 3551 ± 41) and healthy controls (365 ± 11 µm2; 3581 ± 84). Higher systolic BP (β = 9.90, 95% CI, 2.86–16.93), lower eGFR (β = − 0.85; 95% CI, − 1.58 to − 0.13) and higher urine MCR (β = 1.53, 95% CI, 0.32–2.78) were associated with larger areas of CFD. Similar significant associations with systolic BP, eGFR and urine MCR were found with number of CFD. These findings highlight the potential role of choriocapillaris imaging using SS-OCTA as an indicator of systemic microvascular abnormalities secondary to hypertensive disease.

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Section: Discussionmentioning

confidence: 99%

Choriocapillaris microvasculature dysfunction in systemic hypertension

Chua

Tan

et al. 2021

Sci Rep

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“…Minor deviations are described below. (6) hypertensive crisis; (7) hypertensive crises. The search results were then exported to Endnote where duplicates were excluded.…”

Section: Methodsmentioning

confidence: 99%

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

Tan

Yao

et al. 2021

Front. Med.

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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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“…Гипертоническая болезнь (ГБ) и ишемическая болезнь сердца (ИБС) являются ведущими причинами смерти во всем мире [1,2]. Основным осложнением артериальной гипертензии является повреждение микрососудов, связанное с нарушением вазомоторного тонуса и с повышением сосудистого сопротивления в связи с повышением артериального давления (АД) [3]. Основными провоцирующими факторами ИБС являются атеросклероз, спазм сосудов, прогрессирующий хронический воспалительный процесс с утолщением или стенозом артериальной стенки.…”

Section: Introductionunclassified

“…Было доказано, что эти изменения повышают риск развития системных заболеваний, таких как инсульт и сердечно-сосудистые заболевания [6,7]. В исследованиях также рассматривали более крупные сосуды сетчатки (200-300 мкм) с использованием цветных фотографий глазного дна и продемонстрировали корреляцию между диаметром артериол со стадией ГБ [3]. Факторы риска ИБС подробно описаны в литературе и хорошо известны практикующим врачам, но тем не менее сохраняется интерес к поиску методов и других маркеров, которые позволяют стратифицировать пациентов по риску развития ИБС.…”

Section: Introductionunclassified

“…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

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Ophthalmological monitoring in patients with hypertension and coronary heart disease

Lk¹,

Vorobyeva²,

Dgebuadze³

et al. 2021

Russian Journal of Clinical Ophthalmology

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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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Systemic hypertension associated retinal microvascular changes can be detected with optical coherence tomography angiography

Cited by 53 publications

References 57 publications

Choriocapillaris microvasculature dysfunction in systemic hypertension

Choriocapillaris microvasculature dysfunction in systemic hypertension

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

Ophthalmological monitoring in patients with hypertension and coronary heart disease

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