Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Myung Eye Clinic, Daejeon, Republic of Korea.
Retina. 2019 Sep;39(9):1810-1818. doi: 10.1097/IAE.0000000000002216.
To compare retinal thickness between patients with chronic hypertension without retinopathy, hypertensive retinopathy, Keith-Wagener-Barker Grade IV status, and normal controls using spectral domain optical coherence tomography.
In this retrospective study, we analyzed patients who visited our retinal clinic from January 2013 to February 2016. Of those included, 58 eyes of 58 patients were in the healthy control group (Group A), 37 eyes of 37 patients were in the chronic hypertension without retinopathy group (disease duration of at least 10 years; Group B), and 31 eyes of 31 patients with relieved hypertensive retinopathy (Grade IV hypertensive retinopathy a year or more ago but no longer had hypertensive retinopathy at the time of the study; Group C). The thicknesses of the central macula, retinal nerve fiber layer (RNFL), and ganglion cell inner plexiform layer (GCIPL) were measured by spectral domain optical coherence tomography in each group.
The average thicknesses of the central macula, RNFL, and GCIPL layers were lower in Group B than in Group A (P < 0.001, 0.001, and <0.001, respectively). The thicknesses of the three layers were lower in Group C than in Group B (P < 0.001, <0.001, and <0.001, respectively). Of the three groups, the average thicknesses of the central macula, RNFL, and GCIPL were lowest in the Group C (P < 0.001, <0.001, and <0.001, respectively).
The central macula, RNFL, and GCIPL in Group B were significantly thinner than those of healthy eyes, and these retinal changes were more prominent in Group C. Thus, the effects of retinal changes associated with hypertension should be considered when analyzing the thicknesses of the central macular, RNFL, and GCIPL layers in patients with ocular disorders, including retinal, glaucoma, and neuro-ophthalmological diseases.
利用谱域光学相干断层扫描比较慢性高血压无眼底病变、高血压性眼底病变、Keith-Wagener-Barker 分级 IV 期患者与正常对照者的视网膜厚度。
本回顾性研究分析了 2013 年 1 月至 2016 年 2 月期间就诊于我院视网膜门诊的患者。其中，58 只眼（58 例患者）纳入健康对照组（A 组），37 只眼（37 例患者）纳入慢性高血压无眼底病变组（患病时间至少 10 年；B 组），31 只眼（31 例患者）纳入缓解型高血压性眼底病变组（1 年前曾患有Ⅳ级高血压性眼底病变，但研究时已无高血压性眼底病变；C 组）。在各组中均采用谱域光学相干断层扫描测量中央黄斑、视网膜神经纤维层（RNFL）和神经节细胞内丛状层（GCIPL）的厚度。
与 A 组相比，B 组中央黄斑、RNFL 和 GCIPL 平均厚度较低（均 P < 0.001）。与 B 组相比，C 组上述 3 个部位的厚度均较低（均 P < 0.001）。3 组中，C 组中央黄斑、RNFL 和 GCIPL 的平均厚度最低（均 P < 0.001）。
B 组中央黄斑、RNFL 和 GCIPL 厚度明显较健康眼薄，C 组这些视网膜变化更为显著。因此，在分析包括视网膜、青光眼和神经眼科疾病在内的眼部疾病患者中央黄斑、RNFL 和 GCIPL 层厚度时，应考虑与高血压相关的视网膜变化的影响。
