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Doppler Optical Coherence Tomography of Retinal Circulation
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Optical Coherence Tomography Angiography Findings Associated With Accelerated Hypertension.

Salil Mehta1

  • 1Ophthalmology, Lilavati Hospital, Mumbai, IND.

Cureus
|May 30, 2024
PubMed
Summary

Accelerated hypertension can cause vision loss. Optical coherence tomography angiography (OCTA) helps detect retinal microvascular changes and assess risks in these patients.

Keywords:
accelerated hypertensionfundoscopyhypertensionocularoptical coherence tomography angiography

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Area of Science:

  • Ophthalmology
  • Cardiology
  • Nephrology

Background:

  • Accelerated hypertension, defined as blood pressure >180/120 mmHg, is associated with significant systemic and visual morbidity.
  • Fundoscopic signs are common in accelerated hypertension, indicating potential ocular complications.

Purpose of the Study:

  • To evaluate the clinical and optical coherence tomography angiography (OCTA) findings in patients with accelerated hypertension.
  • To explore OCTA's utility in detecting retinal microangiopathy and grading its severity.

Main Methods:

  • Retrospective analysis of 16 patients presenting with accelerated hypertension.
  • Bedside dilated fundus examination, fundus photography, and OCTA of the posterior pole vasculature.
  • Assessment of comorbidities including pre-existing hypertension, chronic kidney disease, and diabetes mellitus type 2.

Main Results:

  • Analysis of 22 eyes revealed Keith Wagener Barker (KWB) grades ranging from 1 to 4.
  • OCTA identified capillary nonperfusion in the superficial capillary plexus in 31.8% of eyes with retinal opacification.
  • Common comorbidities included pre-existing hypertension (81.8%), chronic kidney disease (27.2%), and type 2 diabetes (18.1%).

Conclusions:

  • OCTA is a valuable tool for detecting and grading retinal microangiopathy in accelerated hypertension.
  • OCTA findings can aid in quantifying systemic and ocular risks for improved patient management.
  • Further development of OCTA-based models may enhance risk stratification in hypertensive emergencies.