Alterations of Choroidal Thickness and Circulation in Patients with Hypertensive Choroidopathy

Abstract

Purpose : Hypertensive choroidopathy (HTC) is associated with acute severe hypertension in patients with toxemia of pregnancy, renal disorders, or malignant hypertension. However, the role of choroidal circlation and structue changes in the pathogenesis of HTC remains unclear. The purpose of this study was to investigate the time course changes of central choroidal thickness (CCT) and macular choroidal blood flow in patients with HTC treated with medication for hypertension.

Methods : Retrospective observational case series. Eight eyes of 7 patients with HTC were included in this study (3 males and 4 females; mean age 39.1±15.6). Macular serous retinal detachment (SRD) was observed at the acute phase in all the eyes. The causes of hypertension were essential hypertension (n=3), pregnancy (n=3) and renal failure (n=1). Mean blood pressure (MBP), best-corrected visual acuity (BCVA), and CCT were assessed during the follow-up period. Using laser speckle flowgraphy (LSFG), a recently introduced non-invasive method of measuring the mean blur rate (MBR) of ocular blood flow, the macular choroidal blood flow velocity was evaluated.

Results : With the medication for hypertension, SRD disappeared in all the eyes (mean period, 43.1±37.2 days) and the MBP was decreased (122.1±14.4mmHg and 91.3±14.0mmHg at the initial visit and at the day of SRF absorption, respectively; P<0.01). The mean logMAR value of BCVA was significantly improved with the resolution of SRD (0.21±0.31 and 0.10±0.31, P<0.01). The average MBR was significantly decreased when SRD was absorbed (11.3±4.7 and 7.3±1.9, P<0.01). Similarly, the mean values of CCT decreased (527.1±207.3µm and 351.3±103.9µm, P<0.01). The change rates of CCT and MBR showed a significant positive correlation (P<0.01, R=0.92).

Conclusions : The current data showed that the MBP-lowering medication reduced CCT and MBR with link mutually in patients with HTC, suggesting that HTC at the acute phase with high systemic blood pressure involves hydrostatic pressure elevation in the choroid and subsequent SRD development.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.