Impact of hypertension on retinal capillary microvasculature using optical coherence tomographic angiography.

Autor:	Chua J; Singapore Eye Research Institute, Singapore National Eye Centre.; Academic Clinical Program, Duke-NUS Medical School., Chin CWL; Academic Clinical Program, Duke-NUS Medical School.; National Heart Research Institute Singapore, National Heart Centre Singapore.; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System., Hong J; Singapore Eye Research Institute, Singapore National Eye Centre.; Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Chee ML; Singapore Eye Research Institute, Singapore National Eye Centre., Le TT; National Heart Research Institute Singapore, National Heart Centre Singapore., Ting DSW; Singapore Eye Research Institute, Singapore National Eye Centre.; Academic Clinical Program, Duke-NUS Medical School., Wong TY; Singapore Eye Research Institute, Singapore National Eye Centre.; Academic Clinical Program, Duke-NUS Medical School.; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System., Schmetterer L; Singapore Eye Research Institute, Singapore National Eye Centre.; Academic Clinical Program, Duke-NUS Medical School.; Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.; Department of Clinical Pharmacology.; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.
Jazyk:	angličtina
Zdroj:	Journal of hypertension [J Hypertens] 2019 Mar; Vol. 37 (3), pp. 572-580.
DOI:	10.1097/HJH.0000000000001916
Abstrakt:	Objective: Reduction in capillary density or rarefaction is a hallmark of essential hypertension. We measured the retinal capillary density using noninvasive optical coherence tomographic angiography (OCT-A) in adults with treated systemic hypertension and determined possible correlations with ambulatory blood pressure (BP) and renal parameters. Methods: This observational cross-sectional study consisted of 153 normal eyes from 77 nondiabetic hypertensive adults [mean (SD) age, 58 (9) years; 49% women; 23% poorly controlled BP]. Data on 24-h ambulatory BP monitoring, serum creatinine, and urine microalbumin/creatinine ratio (MCR) were collected. Estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. Retinal capillary density measured with the OCT-A (AngioVue) at superficial (SVP) and deep vascular plexuses (DVP). Linear regression was used to investigate the association of risk factors with capillary density. Results: Retinal capillary density (percentage) at DVP was reduced in patients with poorly controlled BP (SBP = 148 ± 8 mmHg; 27.2 ± 13.0) compared with those with well controlled BP (SBP = 125 ± 9 mmHg; 34.7 ± 11.3). In the multivariable analysis, poorly controlled BP [β = -6.49, 95% confidence interval (CI), -12.39 to -0.59], higher SBP (β = -0.23, 95% CI -0.44 to -0.02) and lower eGFR (β = 6.42, 95% CI 1.25-11.60) were associated with sparser retinal capillary density. Systemic factors were not associated with capillary density at SVP (all P > 0.05). Conclusion: In adults with treated systemic hypertension, retinal capillary density reduced with higher BP and poorer eGFR. These findings highlight the potential role of OCT-A to study early microvascular changes because of systemic hypertension.
Databáze:	MEDLINE
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