Department of Family Medicine, Health Science University, Kartal Dr. Lutfi Kirdar Trainig and Research Hospital , Istanbul, Turkey.
Department of Ophthalmology, Health Science University, Kartal Dr. Lutfi Kirdar Trainig and Research Hospital , Istanbul, Turkey.
Clin Exp Hypertens. 2020 Nov 16;42(8):733-737. doi: 10.1080/10641963.2020.1783548. Epub 2020 Jun 24.
Detection of end-organ damage (EOD) in systemic hypertension is essential for the management of systemic hypertension. We aimed to evaluate subfoveal choroidal thickness (SFCT) and retinal layers' thicknesses by using spectral domain optical coherence tomography (SD‑OCT) in patients with systemic hypertension and to assess the relationship between EOD and SD-OCT parameters.
A total of 189 consecutive patients with systemic hypertension and 100 controls were included. Patients were examined to detect EOD including hypertensive retinopathy (HTRP), left ventricular hypertrophy assessed by transthoracic echocardiography and microalbuminuria assessed by 24-h urine analysis. SFCT, inner plexiform-ganglion cell complex (IP-GCC), peripapillary retinal nerve fiber layer (pRNFL) and central macular thickness (CMT) were measured with SD-OCT.
Patients with systemic hypertension had significantly lower SFCT and retinal layer thicknesses than controls (P˂0.001). In the dilated fundus photographic evaluation, 94 patients with systemic hypertension had HTRP and these patients had lower SFCT, CMT, IP-GCC and pRNFL thicknesses compared to hypertensive patients without HTRP and healthy controls. Patients with EOD had significantly lower SFCT, CMT, IP-GCC and pRNFL thicknesses and as the number of EOD increased, the SFCT decreased significantly. In the multivariate analysis, SFCT was found as an independent predictor of EOD (P˂0.001, odds ratio: 0.0605).
Hypertensive patients, especially with EOD had significantly lower SD-OCT parameters compared to controls. It would be rational to add SD-OCT assessment to conventional hypertensive retinopathy evaluation in patients with systemic hypertension for early diagnosis of end-organ damage, burden of target organ involvement and monitoring anti-hypertensive treatment.
检测系统性高血压中的靶器官损伤（EOD）对于系统性高血压的管理至关重要。我们旨在通过使用频域光学相干断层扫描（SD-OCT）评估系统性高血压患者的中心凹下脉络膜厚度（SFCT）和视网膜各层厚度，并评估 EOD 与 SD-OCT 参数之间的关系。
共纳入 189 例连续的系统性高血压患者和 100 例对照。对患者进行检查以检测 EOD，包括高血压性视网膜病变（HTRP）、经胸超声心动图评估的左心室肥厚和 24 小时尿液分析评估的微量白蛋白尿。使用 SD-OCT 测量 SFCT、内丛状-节细胞复合体（IP-GCC）、视盘周围视网膜神经纤维层（pRNFL）和中心黄斑厚度（CMT）。
与对照组相比，系统性高血压患者的 SFCT 和视网膜层厚度明显较低（P˂0.001）。在眼底散瞳摄影评估中，94 例系统性高血压患者患有 HTRP，与无 HTRP 的高血压患者和健康对照者相比，这些患者的 SFCT、CMT、IP-GCC 和 pRNFL 厚度较低。患有 EOD 的患者的 SFCT、CMT、IP-GCC 和 pRNFL 厚度明显较低，随着 EOD 数量的增加，SFCT 显著降低。在多变量分析中，SFCT 被发现是 EOD 的独立预测因子（P˂0.001，优势比：0.0605）。
与对照组相比，患有高血压的患者，尤其是患有 EOD 的患者，SD-OCT 参数明显较低。对于系统性高血压患者，在常规高血压性视网膜病变评估中添加 SD-OCT 评估以早期诊断靶器官损伤、目标器官受累负担和监测抗高血压治疗可能是合理的。
