Optical coherence tomography angiography and arterial hypertension: A role in identifying subclinical microvascular damage?

Abstract

Introduction: To evaluate retinal microvasculature modifications by means of optical coherence tomography angiography in human subjects diagnosed with arterial hypertension and to assess potential clinical relevance for early diagnosis. Methods: A cross-sectional study of 30 subjects affected by arterial hypertension compared to a matched cohort of healthy patients was conducted. Patients were evaluated by the Outpatient Clinic for Hypertension and the Retina Center, University of Insubria, Varese, Italy. Patients were divided into three groups: Group 1—healthy subjects, Group 2—patients first diagnosed with hypertension, and Group 3—patients with treated hypertension. Optical coherence tomography angiography was performed applying different analysis protocols for macula and optic disk, using an AngioVue OCTA System on an Optovue device. Morphological data were compared to and correlated with clinical vascular parameters, to evaluate preclinical microvascular damage. Results: A significant reduction in deep vascular layer density (Group 1: 59.2% ± 1.5% standard deviation; Group 2: 59.2% ± 2.2% standard deviation; Group 3: 57.8% ± 2.6% standard deviation; p < 0.05) as well as an enlargement of the deep foveal avascular zone area (Group 1: 0.34 ± 0.09 mm2; Group 2: 0.36 ± 0.07 mm2; Group 3: 0.39 ± 0.1 mm2; p < 0.05) was measured in patients with first diagnosed hypertension and in treated patients compared to healthy subjects. We also observed a significant decrease in mean foveal choroidal thickness in affected patients compared to controls (Group 1: 319.68 ± 61.72 µm standard deviation; Group 2: 251.04 ± 63.1 µm standard deviation; Group 3: 262.65 ± 51.08 µm standard deviation; p < 0.05). Our preliminary data did not show a significant correlation with microalbuminuria levels. Discussion: Retinal vascular density showed pathological modifications between healthy subjects and hypertensive patients. These preliminary findings suggest that optical coherence tomography angiography may identify pathological markers of an early hypertensive damage and help monitor disease progression with potential therapeutic advantages.

Optic disc and peripapillary vessel density measured with optical coherence tomography angiography and its associations in Chinese adults: a large population-based study

“…In addition to obesity, other vasculopathic risk factors like hypertension, hyperglycaemic and hyperlipidemia are possible public health conditions which may be closely correlated with ocular microcirculation. [29][30][31][32][33][34] However, results in our study did not suggest presence of hypertension, DM, elevated SBP or DBP or HbA1C or serum lipids were independently associated with the decrease of NFLP VD. The difference of sample size, inclusion criteria and race potentially contributed to the discrepancies in results.…”

Optic Disc and Macular Vessel Density Measured by Optical Coherence Tomography Angiography in Open-Angle and Angle-Closure Glaucoma

“…Fifth, reduced macular VD and increased foveal avascular zone in patients with hypertension have been reported 47,48 . However, the optic disc VD was shown to reduce only in patients with first diagnosis of systemic hypertension but not in patients already treated for systemic hypertension 49 . Wang et al 48 also reported decreased retinal and choroidal VD in the macular region in patients with coronary heart disease.…”

Microvascular and functional changes according to the fundus location of the affected arteriovenous crossing in patients with branch retinal vein occlusion

“…This finding is consistent with that in a study performed in patients with hypertension by Donati et al . [ 37 ] who observed a significant reduction in vessel density in the deep DCP and attributed this change in the microvascular network to thinning of the retinal vessels and loss of capillaries as a result of endothelial injury. Moreover, Koulisis et al .…”