The macular vascular density in hypertensive patients without obvious hypertensive retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Ma Ning ¹ , Li Wei ² , Liu Juejun ¹ , He Tao ¹ ,  Xing Yiqiao ¹

1. Renmin Hospital of Wuhan University, Eye Center, Wuhan 430060, China;
2. Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

Xing Yiqiao, Email: Yiqiao_xing57@whu.edu.cn

Keywords：

Hypertensive retinopathy/diagnosis; Macula lutea/injuries; Microvessels/injuries; Tomography, optical coherence; Regional blood flow

DOI：

10.3760/cma.j.cn511434-20190424-00156

Video：

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Objective To observe the changes of macular vascular density of hypertensive patients without obvious hypertensive retinopathy (HRP).Methods Twenty-three patients (hypertension group) diagnosed as grade 2 or grade 3 essential hypertension in Cardiology Department of Renmin Hospital of Wuhan University from January to April 2019 were enrolled in the study. Among them, there were 13 males and 10 females. The mean age was 61.6 ± 5.6 years, and the mean BCVA was 0.74 ± 0.16. The course of hypertension was more than 7 years; Keith Wagener (K-W) grade was 0 or 1. Fifteen age-matched people without hypertension were selected as the control group, among which included 8 males and 7 females. Their average age was 59.7 ± 4.4 years and the average BCVA was 0.79 ± 0.17, the K-W grades were 0. There was no significant difference (P=0.265, 1.000, 0.563) between the two groups in age (t=1.739), sex ratio (χ²=0.036) or BCVA (t=0.585). All subjects were examined by BCVA, fundus photography and OCTA. OCTA scanned the macular area in the range of 3 mm × 3 mm. The software automatically divided the image into two concentric circles with the macular fovea as the center, which are the inner ring with a diameter of 1 mm (foveal area) and the outer ring with a diameter of 1-3 mm. The blood flow density of the whole, temporal, upper, nasal and lower capillary layers within 3 mm of the macular area, and foveal avascular zone (FAZ) area, central foveal retinal thickness (CFT) were measured.Results Significant differences were observed in the vascular densities of total, temporal, nasal and inferior area of maculas (t=2.188, 2.472, 5.105, 2.734; P=0.037, 0.020, 0.000, 0.010) between the two groups, while no significant differences were evidenced in foveal vascular densities and superior vascular densities (t=0.575, 0.140; P=0.570, 0.889). There was no significant difference in FAZ area or CFT between the two groups (t=0.367, 0.753; P=0.714, 0.457). Macular arches were intact in all hypertension patients.Conclusions The vascular densities of total, temporal, nasal and inferior area of maculas in the hypertension patients without HRP decreased. The area of FAZ did not expand, and the structures of macular arch ring were normal.

Citation： Ma Ning, Li Wei, Liu Juejun, He Tao, Xing Yiqiao. The macular vascular density in hypertensive patients without obvious hypertensive retinopathy. Chinese Journal of Ocular Fundus Diseases, 2020, 36(5): 358-361. doi: 10.3760/cma.j.cn511434-20190424-00156 Copy

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1. Perrone-Filardi P, Coca A, Galderisi M, et al. Non-invasive cardiovascular imaging for evaluating subclinical target organ damage in hypertensive patients: a consensus paper from the European Association of Cardiovascular Imaging (EACVI), the European Society of Cardiology Council on Hypertension, and the European Society of Hypertension (ESH)[J]. Eur Heart J Cardiovasc Imaging, 2017, 18(9): 945-960. DOI: 10.1093/ehjci/jex094.
2. Besharati MR, Rastegar A, Shoja MR, et al. Prevalence of retinopathy in hypertensive patients[J]. Saudi Med J, 2006, 27(11): 1725-1728.
3. 王增武, 王文. 中国高血压防治指南(2018年修订版)解读[J]. 中国心血管病研究, 2019, 17(3): 193-197. DOI: 10.3969/j.issn.1672-5301.2019.03.001.Wang ZW, Wang W. Interpretation of Chinese guidelines for the management of hypertension (2018 revised edition)[J]. Chinese Journal of Cardiovascular Research, 2019, 17(3): 193-197. DOI: 10.3969/j.issn.1672-5301.2019.03.001.
4. 李成武, 庄曾渊, 刘静, 等. 高血压病患者眼底病变分级与眼血流动力学参数的相关性[J]. 眼科, 2017, 26(3): 206-209. DOI: 10.13281/j.cnki.issn.1004-4469.2017.03.013.Li CW, Zhuang ZY, Liu J, et al. Correlation between ocular fundus lesion grading and ocular hemodynamics in patients with essential hypertension[J]. Ophthalmol CHN, 2017, 26(3): 206-209. DOI: 10.13281/j.cnki.issn.1004-4469.2017.03.013.
5. Garrity ST, Iafe NA, Phasukkijwatana N, et al. Quantitative analysis of three distinct retinal capillary plexuses in healthy eyes using optical coherence tomography angiography[J]. Invest Ophthalmol Vis Sci, 2017, 58(12): 5548-5555. DOI: 10.1167/iovs.17-22036.
6. Ruiz-Medrano J, Flores-Moreno I, Peña-García P, et al. Asymmetry in macular choroidal thickness profile between both eyes in a healthy population measured by swept-source optical coherence tomography[J]. Retina, 2015, 35(10): 2067-2073. DOI: 10.1097/IAE.0000000000000590.
7. 徐柒华, 陈惠英, 王军. 欧堡全景200激光扫描检眼镜在老年眼病筛查中的应用[J]. 国际眼科杂志, 2007, 7(6): 1773. DOI: 10.3969/j.issn.1672-5123.2007.06.097.Xu QH, Chen HY, Wang J. Application of Optomap Panoramic 200 in the screening of senile ophthalmopathy[J]. Int Eye Sci, 2007, 7(6): 1773. DOI: 10.3969/j.issn.1672-5123.2007.06.097.
8. Kernt M, Hadi I, Pinter F, et al. Assessment of diabetic retinopathy using nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) compared with ETDRS 7-field stereo photography[J]. Diabetes Care, 2012, 35(12): 2459-2463. DOI: 10.2337/dc12-0346.
9. 曾键. 黄斑区微血管循环及临床意义[J]. 中华眼底病杂志, 1993, 9(3): 186-188.Zeng J. Microvascular circulation in macular region and its clinical significance[J]. Chin J Ocul Fundus Dis, 1993, 9(3): 186-188.
10. Takayama K, Kaneko H, Ito Y.et al. Novel classification of early-stage systemic hypertensive changes in human retina based on OCTA measurement of choriocapillaris[J/OL]. Sci Rep, 2018, 8(1): 5163[2018-10-11]. https://www.nature.com/articles/s41598-018-33580-y. DOI: 10.1038/s41598-018-33580-y.
11. Shin YI, Nam KY, Lee WH, et al. Peripapillary microvascular changes in patients with systemic hypertension: an optical coherence tomography angiography study[J/OL]. Sci Rep, 2020, 10(1): 6541[2020-04-16]. https://www.nature.com/articles/s41598-020-63603-6. DOI: 10.1038/s41598-020-63603-6.
12. Lee WH, Park JH, Won Y, et al. Retinal microvascular change in hypertension as measured by optical coherence tomography angiography[J]. Sci Rep, 2019, 9(1): 156. DOI: 10.1038/s41598-018-36474-1.

Chinese Journal of Ocular Fundus Diseases

The macular vascular density in hypertensive patients without obvious hypertensive retinopathy

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