Changes in Ganglion Cell–Inner Plexiform Layer Thickness and Retinal Microvasculature in Hypertension: An Optical Coherence Tomography Angiography Study

Lim, Hyung Bin; Lee, Min Woo; Park, Jae‐Hyeong; Kim, Kyeung‐Min; Jo, Yeonhwa; Kim, Jung‐Yeul

doi:10.1016/j.ajo.2018.11.016

Cited by 96 publications

(105 citation statements)

References 40 publications

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“…; Lim et al. ). In these studies, HTN patients exhibited significantly decreased superficial capillary plexus vessel and perfusion densities, which were correlated with GC‐IPLs, as compared to the controls.…”

Section: Discussionmentioning

confidence: 98%

Longitudinal changes in the thickness of the ganglion cell–inner plexiform layer in patients with hypertension: a 4‐year prospective observational study

Lee

Lim

et al. 2019

Acta Ophthalmologica

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Purpose: Hypertension (HTN) is expected to accelerate age-related ganglion cell-inner plexiform layer thickness (GC-IPLs) reduction, but there is limited information on the reduction rate of GC-IPLs in HTN patients. We investigate longitudinal changes in the thickness of GC-IPL in patients with HTN. Methods: We performed a prospective, longitudinal and observational study design. Participants were divided into two groups: HTN group (49 eyes) and control group (56 eyes). After the initial visit, GC-IPLs were measured four times at 1-year intervals using spectral-domain optical coherence tomography. The GC-IPL reduction rate was estimated using a linear mixed model and compared between the two groups. Univariate and multivariate generalized linear mixed models were used to identify factors associated with reductions in GC-IPLs over time. Results: In a linear mixed model, the GC-IPL reduction rates for the HTN and control groups were À0.64 (p < 0.001) and À0.19 (p < 0.001) lm/year, respectively, and the interaction between group and follow-up duration was significant (p < 0.001). In the HTN group, all sectors exhibited significant reductions over time (all p < 0.001). Results from univariate and multivariate linear mixed model analyses revealed that age and IOP were significantly associated (p = 0.009 and 0.047, respectively) with reductions in GC-IPLs in HTN patients. Conclusion: Patients with HTN exhibited a significant reduction in GC-IPLs compared to normal subjects. Additionally, age and IOP affected the reduction rate of GC-IPLs in HTN patients. In various ophthalmic diseases, physicians should consider the longitudinal effect of HTN on GC-IPLs.

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Section: Discussionmentioning

confidence: 98%

Longitudinal changes in the thickness of the ganglion cell–inner plexiform layer in patients with hypertension: a 4‐year prospective observational study

Lee

Lim

et al. 2019

Acta Ophthalmologica

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“…Besides, an early reduction of wDVD has been detected in our study. It might be explained that the deep capillary vortexes 27 might be earlier or more frequently to compensate for the lower blood ow and the changes of hypoxia and ischemia in macula as previously reported in patients with hypertension and diabetes mellitus 28,29 .…”

Section: Discussionmentioning

confidence: 74%

Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography angiography

Liu¹,

Chen²,

Lü³

et al. 2020

Preprint

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Background To analyze the blood flow changes of radial peripapillary capillaries (RPC) and macula with time procession in patients with non-arteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCT-A).Methods A total of 21 affected eyes and 19 unaffected eyes from 21 NAION patients, and 40 eyes of 20 healthy individuals were included. Assessments of BCVA, CFP, SD-OCT, and OCT-A were performed on NAION patients at enrollment and at 1-2 weeks, 1-2 months, and 3-6 months post-enrollment. Measures of the thickness of peripapillary retinal nerve fiber layer (wRNFL) and macular ganglion cell complex (wGCC) of the whole image in SD-OCT, vessel density of RPC (wRPC) and superficial and deep vascular complexes (wSVD, wDVD) in the whole image of OCT-A, and their superior- and inferior-hemi values (s/iRNFL, s/iGCC, s/iRPC, and s/iSVD) were assessed.Results Compared to healthy controls, wRPC (p<0.001) and wDVD (P=0.001) were significantly lower in affected eyes at baseline, and there was no significant difference in wSVD (p>0.05). The wRPC and wSVD values of affected eyes were significantly decreased at follow-up time points of 1-2 and 3-6 months compared to baseline (p=0.001, p=0.000; p=0.000, p=0.000). The sRPC values were significantly lower than iRPC at 1-2/3-6 months (p=0.001, p=0.000), and sSVD values were lower than iSVD at 1-2 months (p=0.010). Statistically significant correlations were found between wRPC and wRNFL values at 3-6 months (r=0.626, p=0.022), between wSVD and wGCC at 1-2 weeks and 1-2 months (r=0.570, r=0.436; p=0.007, p=0.048).Conclusion OCT-A revealed a sectorial reduction in vessel density in RPC and macula with the disease progression of NAION from acute to atrophic stages, a classification associated with structural deficits.

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“…Recent studies with OCTA have shown decreased foveal microvascular parameters, increased foveal avascular zone areas in patients with chronic HTN, and relived HTNR. Because of the association between the microvasculature and inner retinal layer thickness, inner retinal thinning may be associated with retinal microcirculation 5,6 . In addition, patients with poorly controlled blood pressure showed a greater decrease in the retinal capillary density compared with patients whose blood pressure is well controlled 31 .…”

Section: Discussionmentioning

confidence: 99%

Peripapillary microvascular changes in patients with systemic hypertension: An optical coherence tomography angiography study

Shin

Nam

Lee

et al. 2020

Sci Rep

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the purpose of this study was to investigate changes in peripapillary microvasculature using optical coherence tomography angiography (octA) in systemic hypertension (Htn) patients. this was a crosssectional study. Based on the duration of Htn, seventy-eight Htn patients were divided into two groups. (HTN group 1: <10 years, 38 eyes; HTN group 2: ≥10 years, 40 eyes) and 90 control subjects. All subjects underwent 6 × 6 mm OCTA scan centered on the optic nerve head. We analyzed peripapillary vessel density (VD) and perfusion density (PD) in superficial capillary plexus among three groups. The average ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL) thicknesses of HTN group 2 were thinner than those of the control group (p = 0.016, and 0.035, respectively). HTN group 2 showed lower peripapillary VD and PD than the control group. However, there were no differences between HTN group 1 and the control group in OCT and peripapillary OCTA parameters. In HTN patients, the peripapillary VD, PD and GC-IPL, RNFL thicknesses correlated significantly. octA showed that the peripapillary VD and pD were lower in Htn patients with a duration ≥10 years compared with those of normal controls. peripapillary microvasculature was correlated with the RnfL and GC-IPL thicknesses. HTN duration should therefore be considered when evaluating peripapillary microvasculature using octA.Cardiovascular disease is one of the more common causes of death in developing country, and hypertension (HTN) is the most common treatable risk factor. According to a US study, approximately 68 million (31%) of patients ≥18 years of age are reported to have HTN 1 , and approximately one billion worldwide are affected by HTN 2 . With advances in medical technology, the life expectancy has been extended, and the number of patients with HTN has increased.Uncontrolled HTN can cause vascular changes in many organ systems, such as the brain, heart, kidneys, and eyes, due to elevated arterial pressure and increased peripheral resistance. Vascular changes in the eye can be directly visualized using funduscopy. Arteriolar narrowing is a hallmark of hypertensive retinopathy (HTNR), and the narrowing being characterized as either focal or diffuse. This occurs when the systemic blood pressure rises to maintain constant blood flow by autoregulation of the retinal circulation. The destruction of the inner blood-retinal barrier and vascular endothelial structure can then lead to cotton wool spots, retinal hemorrhage, and intraretinal lipid deposits.Funduscopy, optical coherence tomography (OCT), and fluorescein angiography (FA) may be helpful in the diagnosis and evaluation of retinal pathological changes in HTN. In our previous OCT study, the ganglion cell-inner plexiform layer (GC-IPL) and peripapillary retinal nerve fiber layer (RNFL) thicknesses were lower in chronic HTN and relieved HTNR patients than normal controls 3,4 , Furthermore, in previous optical coherence tomography angiography (OCTA) studies, foveal microvascular perfusion was...

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Changes in Ganglion Cell–Inner Plexiform Layer Thickness and Retinal Microvasculature in Hypertension: An Optical Coherence Tomography Angiography Study

Cited by 96 publications

References 40 publications

Longitudinal changes in the thickness of the ganglion cell–inner plexiform layer in patients with hypertension: a 4‐year prospective observational study

Longitudinal changes in the thickness of the ganglion cell–inner plexiform layer in patients with hypertension: a 4‐year prospective observational study

Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography angiography

Peripapillary microvascular changes in patients with systemic hypertension: An optical coherence tomography angiography study

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