The macular vascular density in hypertensive patients without obvious hypertensive retinopathy / 中华眼底病杂志

ABSTRACT

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.