Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity, Brockway Rd Floreat 6014, Private Bag 5, Wembley, WA, 6913, Australia.
Australian E-Health Research Centre, Perth, Australia.
Sci Rep. 2021 Jan 13;11(1):1001. doi: 10.1038/s41598-020-79594-3.
Microvascular disease and rarefaction are key pathological hallmarks of hypertension. The retina uniquely allows direct, non-invasive investigation of the microvasculature. Recently developed optical coherence tomography angiography now allows investigation of the fine retinal capillaries, which may provide a superior marker of overall vascular damage. This was a prospective cross-sectional study to collect retinal capillary density data on 300 normal eyes from 150 hypertensive adults, and to investigate possible associations with other organ damage markers. The average age of participants was 54 years and there was a greater proportion of males (85; 57%) than females. Multivariate, confounder adjusted linear regression showed that retinal capillary rarefaction in the parafovea was associated with increased pulse wave velocity (β = - 0.4, P = 0.04), log-albumin/creatinine ratio (β = - 0.71, P = 0.003), and with reduced estimated glomerular filtration rate (β = 0.04, P = 0.02). Comparable significant associations were also found for whole-image vascular-density, for foveal vascular-density significant associations were found with pulse wave velocity and estimated glomerular filtration rate only. Our results indicate that retinal capillary rarefaction is associated with arterial stiffness and impaired kidney function. Retinal capillary rarefaction may represent a useful and simple test to assess the integrated burden of hypertension on the microvasculature irrespective of current blood pressure levels.
微血管病变和稀疏是高血压的主要病理特征。视网膜独特地允许对微血管进行直接、非侵入性的研究。最近开发的光相干断层扫描血管造影术现在可以研究精细的视网膜毛细血管，这可能提供整体血管损伤的优越标志物。这是一项前瞻性横断面研究，旨在收集 150 名高血压成年人的 300 只正常眼睛的视网膜毛细血管密度数据，并研究与其他器官损伤标志物的可能关联。参与者的平均年龄为 54 岁，男性（85；57%）比例高于女性。多变量、混杂因素调整的线性回归显示，黄斑旁视网膜毛细血管稀疏与脉搏波速度增加（β=−0.4，P=0.04）、白蛋白/肌酐比值的对数（β=−0.71，P=0.003）和估计肾小球滤过率降低（β=0.04，P=0.02）有关。全图像血管密度也存在类似的显著相关性，而中心凹血管密度仅与脉搏波速度和估计肾小球滤过率有关。我们的结果表明，视网膜毛细血管稀疏与动脉僵硬和肾功能受损有关。视网膜毛细血管稀疏可能代表一种有用且简单的测试，可以评估高血压对微血管的综合负担，而与当前血压水平无关。
