Hughes Alun D, Martinez-Perez Elena, Jabbar Abu-Sufian, Hassan Assif, Witt Nick W, Mistry Paresh D, Chapman Neil, Stanton Alice V, Beevers Gareth, Pedrinelli Roberto, Parker Kim H, Thom Simon A McG
Clinical Pharmacology, NHLI Division, Faculty of Medicine, Imperial College London, UK.
J Hypertens. 2006 May;24(5):889-94. doi: 10.1097/01.hjh.0000222759.61735.98.
Grading of hypertension severity by fundoscopic appearance is difficult and inaccurate. We investigated whether essential hypertension (EHT) and malignant phase hypertension (MHT) were associated with quantifiable abnormalities of the topology and architecture of the retinal circulation.
The topology and architecture of the retinal microvasculature were compared in images from 20 normotensive subjects, 20 patients with EHT and 20 patients with MHT. Digitized retinal photographs were analysed by a novel multiscale image analysis method using a semi-automated program to quantify geometrical and topological properties of arteriolar and venular trees.
EHT was associated with an increase in the arteriolar length-to-diameter ratio (P < 0.01). There were also alterations in arteriolar topology indicative of rarefaction, including a marked reduction in the number of terminal branches in EHT (P < 0.01). These changes in the arteriolar network were exaggerated in MHT and there was also increased venular tortuosity and venular rarefaction in MHT compared with normotensive subjects.
Hypertension is associated with marked topological alterations in the retinal vasculature, and quantification of these changes may be a useful novel approach to the assessment of target organ damage in hypertension.
通过眼底镜表现来分级高血压严重程度既困难又不准确。我们研究了原发性高血压（EHT）和恶性高血压（MHT）是否与视网膜循环拓扑结构和架构的可量化异常相关。
比较了20名血压正常受试者、20名EHT患者和20名MHT患者图像中视网膜微血管的拓扑结构和架构。使用一种新型多尺度图像分析方法和半自动程序对数字化视网膜照片进行分析，以量化小动脉和小静脉树的几何和拓扑特性。
EHT与小动脉长度与直径比值增加相关（P < 0.01）。小动脉拓扑结构也有表明稀疏化的改变，包括EHT中终末分支数量显著减少（P < 0.01）。小动脉网络的这些变化在MHT中更为明显，并且与血压正常受试者相比，MHT中小静脉迂曲度增加且小静脉稀疏化。
高血压与视网膜血管明显的拓扑改变相关，对这些变化进行量化可能是评估高血压靶器官损害的一种有用新方法。
