Lee Woo Hyuk, Lee Min-Woo, Lim Hyung-Bin, Kim Min-Su, Ryu Cheon Kuk, Han Yong-Seop, Kim Jung-Yeul
Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
Department of Ophthalmology, Gyeongsang University College of Medicine Changwon Hospital, Changwon, Korea.
Acta Ophthalmol. 2022 Feb;100(1):e150-e156. doi: 10.1111/aos.14884. Epub 2021 Apr 21.
Acute and chronic hypertension may have different pathophysiological mechanisms in the retina. Here, we compared the retinal nerve fibre layer (RNFL)/ganglion cell-inner plexiform layer (GC-IPL) thickness ratios of patients with 'relieved' severe hypertensive retinopathy (relieved HTNR) and chronic hypertension without retinopathy (chronic HTN) to those of normal controls.
We performed cross-sectional study. The eyes were divided into the following groups: normal controls (Group A, age ≥50 years; Group D, age <50 years); chronic HTN (Group B, <10 years of HTN; TNHT; Group C, ≥10 years of HTN); and relieved HTNR (previously diagnosed with grade IV HTNR and relieved retinopathy for >1 year; Group E), and the RNFL/GC-IPL thickness ratio was compared among Groups A-C and between Groups D and E.
A total of 379 eyes were included in this study. Groups A-E consisted of 145, 59, 63, 60 and 52 eyes, respectively. The RNFL/GC-IPL thickness ratios were 1.161 ± 0.093, 1.158 ± 0.082 and 1.162 ± 0.089 in groups A-C, respectively, and did not showed a statistically difference (p = 0.966). The RNFL/GC-IPL thickness ratio of groups D and E were 1.169 ± 0.080 and 1.221 ± 0.080, respectively, and showed a statistically difference (p = 0.001).
The RNFL/GC-IPL thickness ratios of the chronic HTN group did not show a difference compared with the normal controls. However, relieved HTNR patients showed a higher ratio than the normal controls. Physicians should be aware that acute hypertensive injury could affect the RNFL/GC-IPL thickness ratio.
急性和慢性高血压在视网膜中可能具有不同的病理生理机制。在此,我们比较了“缓解”的重度高血压性视网膜病变(缓解型高血压性视网膜病变)患者和无视网膜病变的慢性高血压患者(慢性高血压)与正常对照组的视网膜神经纤维层(RNFL)/神经节细胞 - 内网状层(GC - IPL)厚度比。
我们进行了横断面研究。将眼睛分为以下几组:正常对照组(A组,年龄≥50岁;D组,年龄<50岁);慢性高血压组(B组,高血压病程<10年;TNHT;C组,高血压病程≥10年);以及缓解型高血压性视网膜病变组(先前诊断为IV级高血压性视网膜病变且视网膜病变缓解>1年;E组),并比较A - C组之间以及D组和E组之间的RNFL/GC - IPL厚度比。
本研究共纳入379只眼睛。A - E组分别由145、59、63、60和52只眼睛组成。A - C组的RNFL/GC - IPL厚度比分别为1.161±0.093、1.158±0.082和1.162±0.089,且无统计学差异(p = 0.966)。D组和E组的RNFL/GC - IPL厚度比分别为1.169±0.080和1.221±0.080,有统计学差异(p = 0.001)。
慢性高血压组的RNFL/GC - IPL厚度比与正常对照组相比无差异。然而,缓解型高血压性视网膜病变患者的该比值高于正常对照组。医生应意识到急性高血压损伤可能会影响RNFL/GC - IPL厚度比。