Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy

Terheyden, Jan Henrik; Wintergerst, Maximilian W. M.; Pizarro, Carmen; Pfau, Maximilian; Turski, Gabrielle N.; Holz, Frank G.; Finger, Robert P.

doi:10.1167/tvst.9.8.42

Cited by 21 publications

(32 citation statements)

References 32 publications

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“…Rather, we would like to highlight that the CFD metrics is highly dependent on systolic BP control and less on systemic hypertension status, where the flow pattern was essentially similar between persons with well-controlled systemic hypertension and healthy controls. Even though the current study describes individuals with moderate chronic elevation of BP, it is in good agreement with recent study of patients suffering from severe acute elevation of BP (systolic BP ≥ 180 mmHg and/or diastolic BP ≥ 110 mmHg) showing an impaired flow within the choriocapillaris compared to healthy controls 27 . Overall, the alterations in CFD as a result of systemic hypertension follows www.nature.com/scientificreports/ a distinct pattern and is dependent on the systolic BP.…”

Section: Discussionsupporting

confidence: 92%

“…As the BP continues to be poorly controlled, more CFD would appear and this would then have an impact on the density score of CFD. Terheyden et al too showed that the CFD are larger and less numerous (with no changes to the density value) in patients with acute hypertensive crisis 27 . This suggests that size/numbers of CFD may be a more sensitive indicator of microvascular dysfunction in systemic hypertension than density.…”

Section: Mechanisms Underlying Choriocapillaris Flow Deficits In Systmentioning

confidence: 99%

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Choriocapillaris microvasculature dysfunction in systemic hypertension

Chua

Tan

et al. 2021

Sci Rep

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We examined the choriocapillaris microvasculature using a non-invasive swept-source optical coherence tomography angiography (SS-OCTA) in 41 healthy controls and 71 hypertensive patients and determined possible correlations with BP and renal parameters. BP levels, serum creatinine and urine microalbumin/creatinine ratio (MCR) specimens were collected. The estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. The main outcome was choriocapillaris flow deficits (CFD) metrics (density, size and numbers). The CFD occupied a larger area and were fewer in number in the hypertensive patients with poor BP control (407 ± 10 µm2; 3260 ± 61) compared to the hypertensives with good BP control (369 ± 5 µm2; 3551 ± 41) and healthy controls (365 ± 11 µm2; 3581 ± 84). Higher systolic BP (β = 9.90, 95% CI, 2.86–16.93), lower eGFR (β = − 0.85; 95% CI, − 1.58 to − 0.13) and higher urine MCR (β = 1.53, 95% CI, 0.32–2.78) were associated with larger areas of CFD. Similar significant associations with systolic BP, eGFR and urine MCR were found with number of CFD. These findings highlight the potential role of choriocapillaris imaging using SS-OCTA as an indicator of systemic microvascular abnormalities secondary to hypertensive disease.

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Section: Discussionsupporting

confidence: 92%

Section: Mechanisms Underlying Choriocapillaris Flow Deficits In Systmentioning

confidence: 99%

Choriocapillaris microvasculature dysfunction in systemic hypertension

Chua

Tan

et al. 2021

Sci Rep

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“…These findings might reflect a potential link of systemic atherosclerotic disease with ocular microcirculation. Furthermore, our results support existing literature on an association of arterial hypertension with impaired choriocapillaris perfusion 37 , 38 .…”

Section: Discussionsupporting

confidence: 90%

Retinal and choriocapillaris perfusion are associated with ankle-brachial-pressure-index and Fontaine stage in peripheral arterial disease

Wintergerst

Falahat

Holz

et al. 2021

Sci Rep

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The purpose of this prospective case–control study was to assess whether parameters of retinal and choriocapillaris perfusion are altered in patients with peripheral arterial disease (PAD). Patients with PAD and healthy controls were imaged with swept-source optical coherence tomography angiography (OCT-A). Macula centered 3 × 3 mm OCT-A scans were acquired, binarized and perfusion was evaluated for vessel density (VD) and choriocapillaris non-perfused area. Clinical examination and non-invasive assessment included Fontaine staging, ankle-brachial-pressure-index (ABI) and vascular color-coded Doppler sonography. Fifty-two patients with PAD and 23 healthy controls were included. Superficial retinal VD was reduced in patients compared to controls (difference = − 0.013, p = 0.02), decreased with higher Fontaine stage (p = 0.01) and correlated with ABI (r = 0.42, p < 0.0001, 95% confidence interval [CI] 0.23–0.58). Choriocapillaris non-perfused area was larger in patients compared to controls (difference = 3.64%, p = 0.002, 95% CI 1.38–5.90%) and significantly correlated with ABI (r = − 0.22, p = 0.03, 95% CI − 0.40– − 0.03). Multivariate multiple regression analysis revealed a significant association of all OCT-A parameters with ABI and of deep retinal vessel density and choriocapillaris non-perfused area with Fontaine stage. In this first study of retinal and choroidal perfusion in patients with PAD we found both retinal and choroidal perfusion to be significantly impaired. OCT-A parameters could aid as indirect imaging biomarkers for non-invasive PAD staging and monitoring.

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“…ОКТ-А позволяет изучить площадь фовеолярной аваскулярной зоны (ФАЗ), плотность сосудов поверхностного сосудистого сплетения сетчатки (ПСПС) и плотность сосудов глубокого сплетения сетчатки (ПСГС), а также плотность сосудов в слое хориокапилляров (ПСХ). Авторы, изучающие плотность сосудов сетчатки при ГБ, получили противоречивые результаты: увеличение и уменьшение ФАЗ, повышение или снижение ПСПС сетчатки, повышение или снижение ПСГС сетчатки и слоя хориокапилляров [3,11,[16][17][18][19][20][21]. С учетом того, что данные по изучению плотности сосудов сетчатки у пациентов с ГБ, особенно с ГБ и ИБС, противоречивы, и предпринято данное исследование.…”

Section: Introductionunclassified

Ophthalmological monitoring in patients with hypertension and coronary heart disease

Lk¹,

Vorobyeva²,

Dgebuadze³

et al. 2021

Russian Journal of Clinical Ophthalmology

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Aim: to study ophthalmological clinical functional parameters in patients with hypertension and coronary heart disease (CHD) with coronary artery stenosis. Patients and Methods: 30 patients (58 eyes) with hypertension and CHD with coronary artery stenosis (group A) and 30 healthy controls (60 eyes, group B) were examined. Best-corrected visual acuity (BCVA), macular sensitivity (MS) assessed by MAIA microperimetry, central macular thickness (CMT), foveal avascular zone (FAZ) area, vessel density of superficial capillary plexus (SCP VD) and deep capillary plexus (DCP VD) and choriocapillaris measured by optical coherence tomography angiography (OCTA) were evaluated. Results: FAZ area was 0.42±0.03 mm2 in group A and 0.28±0.03 mm2 in group B (p<0.05). SCP VD was 11.4±3.1% in group A and 25.4±2.5% in group B (p<0.05). DCP VD was 22.3±1.1% in group A and 39.2±3.5% in group B (p<0.05). Choriocapillaris VD was 51.2±1.1% in group A and 63.1±1.2% in group B (p<0.05). Correlations between ocular parameters and ejection fraction (EF) were revealed (BCVA: r=0.61, p<0.05; MS: r=0.68, p<0.05; CMT: r=-0.72, p<0.05; FAZ: r=-0.73, p<0.05; SCP VD: r=0.82, p<0.05; DCP VD: r=0.81, p<0.05; choriocapillaris VD: r=0.76, p<0.05). Conclusions: in patients with hypertension and CHD with coronary artery stenosis, significant (p<0.05) reduction in BCVA, MS, SCP VD, DCP VD, and choriocapillaris VD and increase in CMT and FAZ area were detected compared to healthy individuals. Additionally, strong correlations between ocular parameters (FAZ, SCP VD, DCP VD, and choriocapillaris VD) and EF (p<0.05) were identified. OCTA may be recommended to monitor fundus vessels in hypertension and CHD as an effective noninvasive valuable diagnostic tool to verify hypertension and CHD. Keywords: hypertension, coronary heart disease, coronary artery stenosis, hypertensive retinopathy, foveal avascular zone, vessel density, optical coherence tomography angiography. For citation: Moshetova L.K., Vorobyeva I.V., Dgebuadze A. et al. Ophthalmological monitoring in patients with hypertension and coronary heart disease. Russian Journal of Clinical Ophthalmology. 2021;21(2):51–57. DOI: 10.32364/2311-7729-2021-21-2-51-57.

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Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy

Cited by 21 publications

References 32 publications

Choriocapillaris microvasculature dysfunction in systemic hypertension

Choriocapillaris microvasculature dysfunction in systemic hypertension

Retinal and choriocapillaris perfusion are associated with ankle-brachial-pressure-index and Fontaine stage in peripheral arterial disease

Ophthalmological monitoring in patients with hypertension and coronary heart disease

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