Use of optical coherence tomography angiography for assessment of microvascular changes in the macula and optic nerve head in hypertensive patients without hypertensive retinopathy

Hua, Dihao; Xu, Youming; Zeng, Xiangbing; Yang, Ning; Jiang, Meihui; Zhang, Xiao; Yang, Jiayi; He, Tao; Xing, Yiqiao

doi:10.1016/j.mvr.2019.103969

Cited by 50 publications

(57 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 19 Moreover, despite the fact that antihypertensive treatment has been proven to be an influence of retinal microcirculation, 20 such effect was not considered in previous studies about retinal vessel density in patients with hypertension. 14 – 17 , 19 , 21 , 22 Furthermore, the possible association between BP control and the OCTA neurovascular features in hypertensive patients had yet to be investigated. In this study, we conducted a prospective survey of patients with essential hypertension, aiming to discover the changes of retinal perfusion and thickness and their association with BP control in eyes with or without HTNR.…”

mentioning

confidence: 99%

Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study

Peng

Huang

et al. 2020

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

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)

show abstract

mentioning

confidence: 99%

Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study

Peng

Huang

et al. 2020

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

show abstract

“…By contrast, Lee et al found decreased parafoveal SVP vessel density in patients with chronic hypertension (≥ 10 years) or relieved hypertensive retinopathy 15 . Similarly, Hua et al showed that compared with healthy controls, patients with a history of hypertension for 5-10 years or more than 10 years showed decreased parafoveal SVP vessel density 16 . Our study also suggested that BP control is significantly correlated with the microvascular injury in SVP.…”

Section: Discussionmentioning

confidence: 90%

“…Microvascular rarefaction in both SVP and DVP has been found in patients with CKD, but the role of hypertension is yet to be determined 12,13,19,20 . The effect of blood pressure on different layers of retinal microvasculature is controversial, and diverse results have been found in patients with hypertension 10,[15][16][17] . Chua et al measured capillary density within a circular region of 1 mm diameter centered on the fovea in a group of patients with uncomplicated hypertension 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The maximum SBP and within-patient SD of SBP were negatively correlated with SVP vessel density, while positively correlated with SVP flow void area. Both vessel density and flow void area could be biomarkers for retinal vascular injury 8,15,16,31 . More severe vascular injury tends to present a larger flow void area and a lower vessel density.…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension commonly comorbid with CKD; more than 80% of patients with CKD may have hypertension 14 . Nevertheless, the effects of hypertension on different layers of the retinal microvasculature are controversial 10,[15][16][17] . We hypothesized that poor blood pressure (BP) control in patients with CKD may result in various microvascular changes among different retinal layers.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Impact of blood pressure control on retinal microvasculature in patients with chronic kidney disease

Peng

Lee

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Chronic kidney disease (CKD) is an emerging disease worldwide. We investigated the relationship between blood pressure (Bp) control and parafoveal retinal microvascular changes in patients with CKD. This case-control study enrolled 256 patients with CKD (stage 3-5) and 70 age-matched healthy controls. Optical coherence tomography angiography showed lower superficial vascular plexus (SVP) vessel density, lower deep vascular plexus (DVP) vessel density, and larger SVP flow void area in the CKD group. The BP parameters at enrollment and during the year before enrollment were collected in patients with CKD. Partial correlation was used to determine the relationship between BP parameters and microvascular parameters after controlling for age, sex, diabetes mellitus, axial length, and intraocular pressure. The maximum systolic blood pressure (SBP) (p = 0.003) and within-patient standard deviation (SD) of SBP (p = 0.006) in 1 year were negatively correlated with SVP vessel density. The average SBP (p = 0.040), maximum SBP (p = 0.001), within-patient SD of SBP (p < 0.001) and proportion of high BP measurement (p = 0.011) in 1 year were positively correlated with the SVP flow void area. We concluded that long-term SBP was correlated with SVP microvascular injury in patients with CKD. Superficial retinal microvascular changes may be a potential biomarker for prior long-term BP control in these patients. Chronic kidney disease (CKD) is an emerging disease worldwide that is highly prevalent in elderly individuals and in patients with hypertension or diabetes mellitus (DM) 1. Approximately 10-15% of the world's population have CKD 2 , and the prevalence could be as high as 40% among diabetic patients 3. CKD is associated with many systemic vascular complications such as atherosclerosis, cerebrovascular disease, and cardiovascular disease 1. End-stage kidney disease may increase the risk of cardiovascular mortality by 10-30 folds 1. Retinal vasculature, which can be directly visualized using non-invasive tools, has been considered a potential window for systemic vascular complications 4-6. Fundus photography provided a convenient tool for correlating the risk of systemic vascular diseases and retinal vasculature [e.g. the central retinal arteriolar equivalent (CRAE) and the central retinal venular equivalent (CRVE)] 5. However, recent publications showed that systemic diseases may cause retinal capillary alterations preceding any visible pathology in fundus 7-9. Optical coherence tomography angiography (OCTA) technology provides a rapid non-invasive method to quantify microvasculature at the capillary level in the different retinal layers. It could detect early subtle retinal microvascular changes from systemic diseases 8-11. Using OCTA, we had demonstrated decreased parafoveal microvascular vessel densities in both superficial vascular plexus (SVP) and deep vascular plexus (DVP) in patients with CKD 12. eGFR was an independent

show abstract

Retinal microvasculature and vasoreactivity changes in hypertension using optical coherence tomography-angiography

Zeng

Garg²,

Bannai³

et al. 2022

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Use of optical coherence tomography angiography for assessment of microvascular changes in the macula and optic nerve head in hypertensive patients without hypertensive retinopathy

Cited by 50 publications

References 30 publications

Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study

Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study

Impact of blood pressure control on retinal microvasculature in patients with chronic kidney disease

Retinal microvasculature and vasoreactivity changes in hypertension using optical coherence tomography-angiography

Contact Info

Product

Resources

About