Diagnosis of chronic stage of hypertensive retinopathy based on spectral domain optical coherence tomography

Abstract

Hypertensive retinopathy refers to the retinal vascular changes associated with systemic arterial hypertension. Hypertensive retinopathy can be divided into chronic and acute phases. A cross‐sectional study was performed to explore a method of measurement in the diameters of retinal vessels for diagnosis of chronic hypertensive retinopathy based on spectral domain optical coherence tomography (SD‐OCT). The central retinal artery diameter (CRAD), the central retinal vein diameter (CRVD), and the artery‐to‐vein ratio (AVR) were measured. A total of 119 subjects with 119 eyes were included in this study, in which 56 subjects with 56 eyes were included in hypertensive group and 63 subjects with 63 eyes were included in normotensive group. There were significant differences between the two groups in the CRAD ( t = −2.14, P = .04) and the AVR ( t = −2.59, P = .01). The cutoff point of 0.75 was determined by receiver operating characteristic (ROC) curve (area under the curve, AUC 0.786; 95% confidence interval, 95% CI 0.70‐0.87). Multivariate logistic regression analysis showed the probability of AVR below to 0.75 was more in patients with high systolic blood pressure (odds ratio OR 4.39; P = .048), more in male (OR 4.15; P = .004) and more in smokers (OR 5.80; P = .01). Bland‐Altman plots showed small mean bias between the measurements of the two technicians in the CRAD, the CRVD, and the AVR. In summary, application of SD‐OCT is an accurate, reproducible, convenient method for measuring the diameters of retinal vessels. It is valuable for the diagnosis of chronic stage of hypertensive retinopathy.

Retinopatia diabética e retinopatia hipertensiva: uma revisão comparativa

“…O sistema de classificação da retinopatia hipertensiva é baseado em Keith, Wagerner e Barker pelo exame de fundo de olho com um oftalmoscópio. Retinopatia hipertensiva grau I se caracteriza pelo estreitamento das arteríolas, grau ll ocorre um corte arteriovenoso da retina, grau lll define como grau l e ll com presença de manchas algonodosas, hemorragias retinianas, exsudatos duros e a grau lV caracteriza-se por inchaço do disco óptico (FENG X, et al, 2020).…”