Abstract
Purpose :
Systemic hypertension (HTN) has been associated with retinal vasculature changes, such as focal arteriolar narrowing and microaneurysms. While optical coherence tomography-angiography (OCT-A) is a quick and non-invasive imaging device, little has been done to examine the effects of systemic hypertension on the retinal vasculature by OCT-A. Herein, we propose a study to evaluate the retinal vasculature and vasoreactivity of systemic hypertensive patients with OCT-A.
Methods :
Prospective, observational, IRB-approved study of patients with HTN. We excluded patients with chorioretinal diseases and systemic diseases that might affect OCT-A metrics. All eyes were imaged with the Zeiss Angioplex OCT. After a baseline OCT-A was taken, patients were asked to hold their breath for 30 seconds before capturing another OCT-A. Vessel density (VD) and skeletonized vessel density (SVD) of the superficial and deep capillary plexus and choriocapillaris in the macula and optic disc were calculated using ImageJ. A multi-level mixed model tested the association between systemic hypertension and retinal vasculature changes, adjusting for age, sex and hypertensive medications.
Results :
We imaged 9 eyes of 6 patients with HTN and 19 eyes of 12 aged-matched control eyes. We only identified a statistically significant increase in hypertensive patients compared to controls in the VD and SVD of the superficial capillary plexus of the optic nerve (p < 0.05). We found no other significant differences in the OCT-A metrics with or without breath-holding.
Conclusions :
Hypertension was associated with increases in the optic disc VD and SVD. These early results of a small study suggest that there may be OCT-A biomarkers of hypertension control. We did not find breath holding to be a sufficient stressor to bring on additional hypertensive changes. Larger studies are needed to investigate the impact of hypertension severity.
This abstract was presented at the 2019 ARVO Imaging in the Eye Conference, held in Vancouver, Canada, April 26-27, 2019.