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Qingsheng Peng, Yijun Hu, Manqing Huang, Ying Wu, Pingting Zhong, Xinran Dong, Qiaowei Wu, Baoyi Liu, Cong Li, Jinxian Xie, Yu Kuang, Danqing Yu, Honghua Yu, Xiaohong Yang; Retinal Neurovascular Impairment in Patients with Essential Hypertension: An Optical Coherence Tomography Angiography Study. Invest. Ophthalmol. Vis. Sci. 2020;61(8):42. doi: https://doi.org/10.1167/iovs.61.8.42.
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To investigate retinal neurovascular structural changes in patients with essential hypertension.
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 mm2) were measured by optical coherence tomography angiography (OCTA).
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) (GC-IPL, r = –0.160, P = 0.050; RNFL, r = –0.282, P = 0.001) and were positively correlated with SVP (GC-IPL, r = 0.267, P = 0.002; RNFL, r = 0.361, P < 0.001) and RPC density (GC-IPL, r = 0.298, P < 0.001; RNFL, r = 0.663, P < 0.001). Among subjects with grade 2 or 3 retinopathy, the superior RNFL was significantly thinner in patients with high HBPM level than in those with normal HBPM level (grade 2, P = 0.016; grade 3, P = 0.006).
Reduction of retinal vessel density and RNFL thickness is observed in patients with HTNR and is inversely associated with level of HBPM.
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