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

• Published in: Investigative ophthalmology & visual science Vol. 61; no. 8; p. 42
• Main Authors: Peng, Qingsheng, Hu, Yijun, Huang, Manqing, Wu, Ying, Zhong, Pingting, Dong, Xinran, Wu, Qiaowei, Liu, Baoyi, Li, Cong, Xie, Jinxian, Kuang, Yu, Yu, Danqing, Yu, Honghua, Yang, Xiaohong
• Format: Journal Article
• Language: English
• Published: United States The Association for Research in Vision and Ophthalmology 01.07.2020
• Subjects: Angiography - methods; Blood Pressure Monitoring, Ambulatory - methods; Clinical and Epidemiologic Research; Cross-Sectional Studies; Essential Hypertension - complications; Essential Hypertension - diagnosis; Essential Hypertension - physiopathology; Female; Humans; Hypertensive Retinopathy - diagnosis; Hypertensive Retinopathy - physiopathology; Male; Microvessels - diagnostic imaging; Middle Aged; Retina - diagnostic imaging; Retinal Ganglion Cells - pathology; Retinal Vessels - diagnostic imaging; Retinal Vessels - pathology; Severity of Illness Index; Tomography, Optical Coherence - methods
• ISSN: 1552-5783; 0146-0404; 1552-5783
• DOI: 10.1167/iovs.61.8.42

To investigate retinal neurovascular structural changes in patients with essential hypertension. 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 mm2) were measured by optical coherence tomography angiography (OCTA). 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) (GC-IPL, r = -0.160, P = 0.050; RNFL, r = -0.282, P = 0.001) and were positively correlated with SVP (GC-IPL, r = 0.267, P = 0.002; RNFL, r = 0.361, P < 0.001) and RPC density (GC-IPL, r = 0.298, P < 0.001; RNFL, r = 0.663, P < 0.001). Among subjects with grade 2 or 3 retinopathy, the superior RNFL was significantly thinner in patients with high HBPM level than in those with normal HBPM level (grade 2, P = 0.016; grade 3, P = 0.006). Reduction of retinal vessel density and RNFL thickness is observed in patients with HTNR and is inversely associated with level of HBPM.