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Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
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Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography

Qingsheng Peng1,1, Yijun Hu1,1,1, Manqing Huang1

  • 1,.

Investigative Ophthalmology & Visual Science
|July 30, 2020
PubMed

Insights

Essential hypertension patients show reduced retinal vessel density and nerve fiber layer thickness, linked to higher blood pressure. These changes worsen with hypertensive retinopathy severity.

Area of Science:

  • Ophthalmology
  • Cardiology
  • Medical Imaging

Background:

  • Essential hypertension is a major risk factor for cardiovascular and cerebrovascular diseases.
  • Hypertensive retinopathy (HTNR) is a complication of essential hypertension affecting the retinal vasculature.
  • Understanding retinal structural changes in hypertension is crucial for early detection and management.

Purpose of the Study:

  • To investigate retinal neurovascular structural changes in patients with essential hypertension.
  • To correlate these changes with the severity of hypertensive retinopathy and home blood pressure monitoring levels.

Main Methods:

  • An observational, cross-sectional study involving 169 non-diabetic essential hypertensive patients and 30 healthy controls.
  • Optical coherence tomography angiography (OCTA) was used to measure peripapillary retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GC-IPL), and macular vascular plexus density (superficial and deep).
  • Patients were categorized into groups with and without hypertensive retinopathy (HTNR) and compared to a control group.

Main Results:

  • Deep vascular plexus (DVP) density was significantly reduced in hypertensive patients (with and without HTNR) compared to controls.
  • Ganglion cell-inner plexiform layer (GC-IPL) thickness, RNFL thickness, and superficial vascular plexus (SVP) and radial peripapillary capillary (RPC) density were significantly decreased in patients with HTNR compared to controls or those without HTNR.
  • GC-IPL and RNFL thickness were negatively correlated with HTNR severity and home blood pressure monitoring (HBPM) levels, and positively correlated with SVP and RPC density.

Conclusions:

  • Hypertensive retinopathy is associated with significant reductions in retinal vessel density and RNFL thickness.
  • These retinal neurovascular changes are inversely associated with the level of home blood pressure monitoring.
  • The findings highlight the impact of hypertension on retinal structures and suggest potential biomarkers for disease progression.
Abstract

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