Abstract:
We have previously reported lower foveolar choroidal blood flow in eyes with increasing AMD severity. We have now investigated the effect of Systemic Hypertension (SH) on the foveolar choroidal circulation in patients with AMD.
This study included 163 study eyes with early AMD characteristics of 124 AMD patients. AMD study eyes had visual acuity of 20/40 or better and drusen ≥63µ, and/or RPE hypertrophy. Seventeen of these patients had choroidal neovascularization (CNV) in the fellow eye. Fifty two patients had a history of SH and forty six (88%) of these patients were receiving antihypertensive medication. Following pupillary dilatation, laser Doppler flowmetry (Oculix) was used to assess relative choroidal blood velocity (ChB Vel), volume (ChB Vol) and flow (ChB Flow) in the center of the fovea of the study eyes. Differences in the mean circulatory parameters between groups of eyes were assessed using a form of the student’s t–test with adjustment for the correlation between eyes of the same patient.
AMD patients with SH showed a 17.5% decrease in ChB Flow in comparison with those without SH (t–test for differences in means, p = 0.007). This association was maintained after adjustments for age, gender, current smoking status, IOP and severity of AMD.
AMD patients with SH have lower ChB Flow than those without SH. The presence of decreased blood flow in patients with SH, a known risk factor for CNV in AMD, suggests that ischemia may play a role in the development of CNV, in a similar way to what happens in other vascular tissues.
Keywords: age-related macular degeneration • blood supply