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Title: Impact of hypertension on retinal capillary microvasculature using optical coherence tomographic angiography
Authors: Chua, Jacqueline
Chin, Calvin Woon Loong
Hong, Jimmy
Chee, Miao Li
Le, Thu-Thao
Ting, Daniel Shu Wei
Wong, Tien Yin
Schmetterer, Leopold
Keywords: Science::Medicine
Issue Date: 2019
Source: Chua, J., Chin, C. W. L., Hong, J., Chee, M. L., Le, T.-T., Ting, D. S. W., . . . Schmetterer, L. (2019). Impact of hypertension on retinal capillary microvasculature using optical coherence tomographic angiography. Journal of Hypertension, 37(3), 572-580. doi:10.1097/hjh.0000000000001916
Project: NMRC/CG/C010A/2017 
Journal: Journal of Hypertension 
Abstract: 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.
ISSN: 0263-6352
DOI: 10.1097/hjh.0000000000001916
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Rights: © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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