Fundus autofluorescence in chronic essential hypertension

Area of Science:

• Ophthalmology
• Cardiology
• Medical Imaging

Background:

• Chronic essential hypertension (HTN) can lead to retinal vascular changes.
• Fundus autofluorescence (FAF) imaging provides insights into retinal pigment epithelium health.
• Detecting early ocular changes associated with HTN is crucial for patient management.

Purpose of the Study:

• To investigate and characterize fundus autofluorescence (FAF) patterns in patients diagnosed with chronic essential hypertension (HTN).
• To identify potential FAF biomarkers indicative of hypertensive retinopathy.

Main Methods:

• A case-control study involving 35 patients with chronic essential HTN (>5 years) and 31 healthy volunteers.
• Fundus autofluorescence (FAF) imaging of the right eye was performed using Heidelberg retina angiography.
• FAF images were independently assessed by two masked retinal specialists.

Main Results:

• A statistically significant higher prevalence of a doughnut-shaped hyper-autofluorescence ring in the central macula was found in the hypertensive group (25.7%) compared to controls (6.5%) (P = 0.036).
• Hypo- and/or hyper-autofluorescence patches outside the fovea were observed more in hypertensive patients (22.9%) than controls (6.5%), though not statistically significant (P = 0.089).
• No significant difference in hypo-autofluorescence around the optic disc was noted between groups (31.4% vs. 25.8%, P = 0.615).

Conclusions:

• A hyper-autofluorescent ring in the central macula, appearing doughnut-shaped, may represent a novel FAF sign associated with chronic essential hypertension.
• FAF imaging could potentially aid in the early detection and monitoring of hypertensive effects on the retina.