[Retinal hemodynamics in patients with arterial hypertension]

Arterial hypertension is a risk factor for the development of retinal, cerebral and renal microangiopathy. Therefore, a prospective study was started to investigate the progression of retinal microangiopathy in hypertensive patients. Initially, 254 patients were examined in a cross-sectional study. Following an ophthalmological examination, retinal hemodynamics were quantified by means of video-fluorescence angiography. Moreover, blood fluidity (hematocrit, plasma viscosity and erythrocyte aggregation) was analyzed. The severity of the retinal changes was defined according to the Neubauer classification. One hundred (40%) patients showed retinal changes corresponding to stage I; 133 (52%) were classified as stage II. Hypertensive retinopathy (stage III and IV) was encountered in 20 (8%) patients. Arm-retina time was significant prolonged among the hypertensive patients compared with a control group. Arteriovenous passage time showed no significant differences between hypertensive patients and reference values. Plasma viscosity was significantly increased in hypertensive patients and showed a significant increase with progression of the retinal changes. Hematocrit and erythrocyte aggregation were normal among the patients studied. The present findings show an alteration in blood fluidity among hypertensive patients, whereas retinal microcirculation showed no significant disturbances. Follow-up studies are planned to assess the development of retinal microcirculatory changes among hypertensive patients.