Choriocapillaris microvasculature dysfunction in systemic hypertension

Abstract

Purpose : The choriocapillaris layer in the eye is one of the densest layers of capillary vasculature in humans and may be affected by early microvascular changes as a result of uncontrolled systemic hypertension. To examine the choriocapillaris microvasculature using a non-invasive swept-source optical coherence tomography angiography (SS-OCTA) in healthy controls and hypertensive patients and determined possible correlations with BP and renal parameters.

Methods : A prospective study of 41 healthy controls and 71 hypertensive patients with varying blood pressure (BP) control. BP levels, serum creatinine and urine microalbumin/creatinine ratio (MCR) specimens were collected. The estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. The main outcome was choriocapillaris flow deficits (CFD) metrics (density, size and numbers).

Results : The CFD occupied a larger area and were fewer in number in the hypertensive patients with poor BP control (407 + 10 µm²; 3260 + 61) compared to the hypertensives with good BP control (369 + 5 µm²; 3551 + 41) and healthy controls (365 + 11 µm²; 3581 + 84). Higher systolic BP (β=9.90, 95% CI, 2.86 to 16.93), lower eGFR (β = -0.85; 95% CI, -1.58 to -0.13) and higher urine MCR (β=1.53, 95%CI, 0.32 to 2.78) were associated with larger areas of CFD. Similar significant associations with systolic BP, eGFR and urine MCR were found with number of CFD.

Conclusions : These findings highlight the potential role of choriocapillaris imaging using SS-OCTA as an indicator of systemic microvascular abnormalities secondary to hypertensive disease.

This is a 2021 ARVO Annual Meeting abstract.