Abstract
Purpose :
Hypertension (HTN), or high blood pressure, has been shown to induce changes in the retinal vasculature, such as focal arteriolar narrowing and microaneurysm. Optical coherence tomography angiography (OCT-A), a fast and non-invasive imaging device, has emerged as a novel tool to evaluate the retinal microvasculature in many chorioretinal vascular diseases. However, there is a lack of literature on the use of OCT-A devices in systemic HTN. Herein, we evaluated the relationship between systemic HTN and microvascular changes in the retina using OCT-A.
Methods :
This is a retrospective review conducted at Massachusetts Eye and Ear Infirmary (MEEI). All patients were imaged using the Optovue RTVue. Patients with systemic HTN were included. Patients with history of chorioretinal diseases including diabetic retinopathy, retinal vein occlusion, ocular ischemic syndrome, age-related macular degeneration, macular telangiectasia, epiretinal membrane, as well as history of diabetes mellitus were excluded from analysis. Foveal avascular zone (FAZ) area and vessel densities (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) were calculated utilizing ImageJ software. A multi-level mixed model using the Statistical Analysis Software (SAS) was employed for data analysis.
Results :
Seven patients (n = 7 eyes) with HTN were included in the comparison group and 16 patients (n = 19 eyes) without HTN were selected for the control group. No significant difference was found in SCP FAZ (p = 0.545), DCP FAZ (p = 0.102), SCP VD (p = 0.614), DCP VD (p = 0.536), or CC VD (p = 0.497) between patients with and without HTN.
Conclusions :
OCT-A is a nascent imaging technology with vast clinical applications, including those related to chorioretinal diseases and potentially systemic disorders that induce retinal vascular changes. Although hypertension has been known to alter the retinal vasculature, we found no significant difference in the retinal vessel densities by OCT-A imaging in this small cohort. A larger patient sample, including patients with more severe systemic hypertensive disease, may yield better biomarkers of hypertension control.
This abstract was presented at the 2019 ARVO Imaging in the Eye Conference, held in Vancouver, Canada, April 26-27, 2019.