Evaluation of optical coherence tomography in patients with coronary artery disease and systemic hypertension

Systemic hypertension and coronary artery disease (CAD) cause widespread vascular and neurodegenerative changes, including in the retina. Optical coherence tomography (OCT) offers a noninvasive means to visualise these changes, serving as a potential marker of systemic vascular health. Retinal layers like the peripapillary retinal nerve fiber layer (p-RNFL) and ganglion cell-inner plexiform layer (GC-IPL) are especially vulnerable to vascular damage, making them useful indicators of cardiovascular risk. This study aimed to evaluate and compare the p-RNFL and GC-IPL thickness among hypertensive individuals with and without CAD and healthy controls.

This prospective observational study included 140 participants divided into three groups: healthy controls (Group A, n = 40), hypertensives without CAD (Group B, n = 50), and hypertensives with CAD (Group C, n = 50). All subjects underwent comprehensive ophthalmic evaluation, including spectral-domain-OCT, to measure p-RNFL and GC-IPL thickness in both eyes. Data were analyzed using analysis of variance with a significance threshold of P < 0.05.

Both p-RNFL and GC-IPL were significantly thinned in hypertensive subjects, especially those with CAD. Group A had the highest mean RNFL (114.11 ± 10.09 μm) and GC-IPL (85.07 ± 2.30 μm), whereas Group C showed the lowest (RNFL: 84.90 ± 11.81 μm; GC-IPL: 105.97 ± 11.72 μm). Differences were significant (P < 0.001).

OCT can find early signs of retinal nerve damage related to high blood pressure and CAD, indicating it can be a helpful noninvasive method for checking and tracking heart health risks.