PERSONALIZED CHARACTERISTICS OF MORPHOMETRIC AND FUNCTIONAL PARAMETERS OF RETINA IN ARTERIAL HYPERTENTION ACCORDING TO OPTICAL COHERENCE TOMOGRAPHY-ANGIOGRAPHY DATA
Abstract
In recent years, the study of the structural and functional state of the retina in patients with the hypertension stage of the I-IInd type with the usage of optical coherence tomography with angiography, is the subject of particular interest.
It was examined 54 patients with the I- II stage of hypertension, aged 35 to 62 years, who did not receive antihypertensive therapy. Visualization of retinal structures was performed using an optical coherence tomograph (RTVue XR Avanti OCTA (Optovue, Inc, with AngioVue Software 2.0) with angiography function.
A decrease in visual acuity was found in 56.67% of patients with hypertension of the I stage, and – in 79.17% of patients with the II stage.
From the retinal arterioles it was detected an increase in their tone, especially among patients with hypertension of the II stage. On the part of capillaries, among patients of the main group, their tortuosity was noted – in 62.5% of patients with the II stage of AH, also in 54.17% of cases it was revealed a granular blood flow. Also among this group of patients, microaneurysms were revealed in a third of patients, areas of depletion were revealed in 41.67% of patients.
Among extravascular disorders, in patients with I-II degree AH, were revealed hemorrhages, retinal edema, thickening of the neuroepithelium and pleximorphic layer, smoothing of the foveolar fossa, edema of the macular area, also it was detected accumulation of fluid between the layers.
The study of the peripapillary zone of the retina revealed a significant thickening of the layer of nerve fibers in patients with the I stage of AH up to (176.4 ± 9,75) μm in 33.33% of people, under the II stage – to (190,24 ± 12,53) μm, in 54.17% of cases, against the index rules – (10 2.5 ± 6, 47) μm. In 12.5% of cases, the RNFL index was significantly lower than the obtained norm – (93.78 ± 6.19) μm.
Currently, it is necessary to continue the study of the retina in patients with hypertension to determine the risks of damage caused to target organs and evaluate the effectiveness of prescribed antihypertensive therapy.
References
2. Chalam, K. & Sambhav, K. (2016). Optical coherence tomography Angiography in retinal diseases. Journal of Ophthalmic Vision and Research. 11 (1), 84 – 92. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/27195091/ (accessed 15 January 2021).
3. Chobanian, A.V., Bakris, G.L., Black, H.R. et al. (2003). For the National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA. 289 (7), 2560 – 71.
4. Forouzanfar, M.H., Liu, P., Roth, G.A. et al. (2017). Global burden of hypertension and systolic blood pressure of at least 110-115 mm Hg. JAMA. 317 (2), 165 – 82.
5. Hagag, A.M., Gao, S.S. & Huang, D. (2017). Optical coherence tomographic angiography: Technical principles and clinical application in ophthalmology. Taiwan J. Ophthalmol. 7 (3), 115–29.
6. Hoppe, S.A., Antonis, P., Adam, D., et al. (2007). Arterial pulsewave velocity but not augmentation index is associated with coronary artery disease extent and severity: implications for arterial transfer function applicability. J. Hypertens. 25(10), 2105 – 09.
7. Hussain, N., Hussain, A. (2016). Diametric measurement of foveal avascular zone in healthy young adults using optical coherence tomography angiography. Int. J. Retin. Vitr. 2 (1), 27.
8. Jia, Y., Tan, O., Tokayer, J., Potsaid, et al. (2012). Amplitude-decorrelation angiography with split spectrum with optical coherence tomography. Optics express. 20 (4), 4710 – 25.
9. Jumar, A. at al., (2018). Improving retinal capillary thinning after valsartan treatment in patients with hypertension. J. Wedge. Hypertension (Greenwich). 18 (11), 1112 – 8.
10. Kanski, D. (2009). Clinical ophthalmology: a systematic approach / 2nd ed.; – Wroclaw: Elsevier Urban & Partner. – 944 p.
11. Khaisheva L.A., Shlyk S.V., Glova S.E., Bykovskaya T.Yu. (2010). Farmatsevticheskoya korektsіya sosudestіkh narusheniy v bol'nіkh na arterial'noyu gіpertenzіyu [Pharmaceutical correction of vascular disturbances in patients with arterial hypertension]. Russian Journal of Cardiology. Vol.10. No.5. pp.35-40. Retrieved from: https://russjcardiol.elpub.ru/jour/article/view/1492?locale=en (accessed 10 January 2021).
12. Kotlyar K.E., Drozdova G.A., Shamshinova A.M. (2007). Gemodinamіka oka ta suchasnі metodi yogo doslіdzhennya. Chastina III: Neіnvazivnі metodi krovopostachannya ochey [Hemodynamics of the eye and modern methods of its research. Part III: Non-invasive methods of eye blood supply] 2. pp. 64-71. Retrieved from: https://cyberleninka.ru/search?q=Kotlyar%20K.E.%2C%20Drozdova%20G.A.%2C%20Shamshinova%20A.M.&page=1 (accessed 17 January 2021).
13. Lavia, C., Bonnin, S. and others. (2019). Vessel density of superficial, intermediate and deep capillary plexuses using optical coherence tomography Angiography. Retina. 39(2), 247 – 258.
14. Lee, W.H. et al. (2018). Microvascular changes of the retina in hypertension, measured by optical coherence tomography Angiography. Scientific reports. 9(156), 1 – 7.
15. Lumbroso, B., Ristoli, M. (2014). Optical coherence tomography. A practical guide. / Per. With English M.: Panfilov Publishing House; BINOM. Laboratory of Knowledge. – 208 p.
16. Park J.J., Soetikno B.T., Fawzi A.A. (2016). Characterization of the Middle Capillary Plexus Using Optical Coherence Tomography Angiography in Healthy and Diabetic Eye. Retina. 36 (11), 2039 – 50.
17. Plante, G.E. (2002). Vascular response to stress in health and disease. Metabolism. 51 (6), 25 – 30.
18. Sampson, D.M. et al. (2017). Influence of axial length variation on retinal vascular surface density and measurement of avascular zone area of foveal zone by means of optical coherence tomography Angiography. Retina. 58 (7), 3065 – 72.
19. Schneider, R., Rademacher, M., Wolf, S. (1993). Lacunar infarcts and white matter attenuation: ophthalmologic and microcirculatory aspects of the pathophysiology. Stroke. 24, 1874 – 1879.
20. Triantafill, A. and others. (2014). Accumulation of microvascular lesions of target organs in newly diagnosed patients with hypertension. J Am Soc Hypertens. 8, 542.
21. Tultseva S.N., Astakhov Y.S., Rukhovets A.G., Titarenko A.I. (2017). Informativnost' OST-angiografy" v sochetanii s isledovaniyami regional'noy gemodinamiki pri oklyuzii ven setchatki [Informativeness of OCT-angiography in combination with researches of regional hemodynamics at an occlusion of retinal veins]. Ophthalmol. statements. vol. 10. no. 2. pp. 40. Retrieved from: https://www.researchgate.net/scientific-contributions/A-G-Rukhovets-2129752686 (accessed 20 February 2021).
22. Yu, J., Jiang, C., Wang, X. et al. (2015). Macular perfusion in healthy chinese: An optical coherence tomography angiogram study. Investig Ophthalmol. Vis. Sci. 561(5), 3212 – 17.
Abstract views: 154 PDF Downloads: 124