
Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study
Author(s) -
Qingsheng Peng,
Yijun Hu,
Manqing Huang,
Ying Wu,
Pingting Zhong,
Xiao Dong,
Qiaowei Wu,
Baoyi Liu,
Cong Liu,
Jiaxin Xie,
Yu Kuang,
Danqing Yu,
Honghua Yu,
Xiaohong Yang
Publication year - 2020
Publication title -
investigative ophthalmology and visual science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.935
H-Index - 218
eISSN - 1552-5783
pISSN - 0146-0404
DOI - 10.1167/iovs.61.8.42
Subject(s) - medicine , ophthalmology , nerve fiber layer , retinal , neurovascular bundle , optical coherence tomography , fluorescein angiography , retina , surgery , physics , optics
Purpose To investigate retinal neurovascular structural changes in patients with essential hypertension. Methods This observational cross-sectional study consisted of 199 right eyes from 169 nondiabetic essential hypertensive patients, divided into groups as follows: group A, 113 patients with hypertensive retinopathy (HTNR); group B, 56 patients without HTNR; and a control group of 30 healthy subjects. Peripapillary retinal nerve fiber layer (RNFL), radial peripapillary segmented (RPC), ganglion cell–inner plexiform layer (GC-IPL), and superficial (SVP) and deep (DVP) vascular plexus density at the macula (6 × 6 mm 2 ) were measured by optical coherence tomography angiography (OCTA). Results DVP density was significantly reduced in groups A and B compared to the control group (group A DVP, P = 0.001; group B DVP P = 0.002). GC-IPL, RNFL thickness, and RPC and SVP density in group A were significantly decreased compared to the control group or group B (all P < 0.05). In hypertensive patients, GC-IPL and RNFL thickness were negatively correlated with severity of HTNR (GC-IPL, r = –0.331, P < 0.001; RNFL, r = –0.583, P < 0.001) and level of home blood pressure monitoring (HBPM) (GC-IPL, r = –0.160, P = 0.050; RNFL, r = –0.282, P = 0.001) and were positively correlated with SVP (GC-IPL, r = 0.267, P = 0.002; RNFL, r = 0.361, P < 0.001) and RPC density (GC-IPL, r = 0.298, P < 0.001; RNFL, r = 0.663, P < 0.001). Among subjects with grade 2 or 3 retinopathy, the superior RNFL was significantly thinner in patients with high HBPM level than in those with normal HBPM level (grade 2, P = 0.016; grade 3, P = 0.006). Conclusions Reduction of retinal vessel density and RNFL thickness is observed in patients with HTNR and is inversely associated with level of HBPM.