Adenigba Peter T, Adekanmi Ademola J, Ogun Olufunmilola A
Department of Radiology, University College Hospital Ibadan, Nigeria.
Department of Radiology, College of Medicine, University of Ibadan, Nigeria.
Niger Med J. 2023 Feb 24;63(5):385-393. eCollection 2022 Sep-Oct.
Haemodynamic alterations of the retrobulbar circulation are sequelae of untreated, long-standing hypertension. Early evaluation of the retrobulbar blood flow is very crucial to prevent irreversible ocular complications. The objective of this study was to evaluate the differences in central retinal artery (CRA) and ophthalmic artery (OA) haemodynamics in adult hypertensive and non-hypertensive subjects.
This prospective, comparative cross-sectional study was conducted among 63 hypertensives and 75 normotensive controls. Using Doppler ultrasonography, the CRA and OA Doppler velocimetry parameters among cases and controls were evaluated and analysed.
The CRA Peak Systolic Velocity (PSV) and End-diastolic velocity (EDV) was 7.54 ± 2.60cm/s and 2.99 ± 1.15cm/s (p<0.001) in hypertensives but 10.8 ± 2.51cm/s and 4.50 ± 1.25cm/s) p<0.001 in controls. The systolic/diastolic ratio (S/D) in cases was 2.64 ± 0.75 and 2.44 ± 0.38 p=0.045 in controls. The CRA's Pulsatility Index (PI) between cases and controls was not statistically significant, p =0.082. Furthermore, the CRA's PSV, PI, Resistivity index (RI) and S/D, were higher among subjects with stage 1 compared to stage 2 hypertension (p=0.004; p=0.027; p<0.001 and p=0.001 respectively). The OA mean EDV in hypertensives was 4.57 ± 1.97 and in controls= 5.31 ± 1.79 (p=0.022), while the OA mean RI and Peak Ratio, p=0.009 and 0.003, respectively, were higher in stage 1 hypertension.
The Central retinal and ophthalmic artery blood flow parameters were significantly lower among hypertensive cases. Also, hypertensive stage 2 cases had significantly lower blood flow and vascular impedance parameters in the CRA and both Central retinal and ophthalmic artery, respectively.
球后循环的血流动力学改变是未经治疗的长期高血压的后遗症。早期评估球后血流对于预防不可逆的眼部并发症非常关键。本研究的目的是评估成年高血压患者和非高血压患者视网膜中央动脉（CRA）和眼动脉（OA）血流动力学的差异。
本前瞻性、比较性横断面研究在63例高血压患者和75例血压正常的对照者中进行。使用多普勒超声检查，对病例组和对照组的CRA和OA多普勒测速参数进行评估和分析。
高血压患者的CRA收缩期峰值速度（PSV）和舒张末期速度（EDV）分别为7.54±2.60cm/s和2.99±1.15cm/s（p<0.001），而对照组分别为10.8±2.51cm/s和4.50±1.25cm/s（p<0.001）。病例组的收缩/舒张比（S/D）为2.64±0.75，对照组为2.44±0.38，p=0.045。病例组和对照组之间CRA的搏动指数（PI）无统计学意义，p =0.082。此外，与2期高血压患者相比，1期高血压患者的CRA的PSV、PI、阻力指数（RI）和S/D更高（分别为p=0.004；p=0.027；p<0.001和p=0.001）。高血压患者的OA平均EDV为4.57±1.97，对照组为5.31±1.79（p=0.022），而1期高血压患者的OA平均RI和峰值比分别为p=0.009和0.003，更高。
高血压病例的视网膜中央动脉和眼动脉血流参数显著降低。此外，2期高血压病例的CRA以及视网膜中央动脉和眼动脉的血流和血管阻抗参数分别显著降低。
