Retinal microvascular and structural changes in intracranial hypertension patients correlate with intracranial pressure

AIMS: We aimed to evaluate the retinal microvascular and structural changes in intracranial hypertension (IH) patients compared with an age‐ and sex‐matched control group. We also investigated the association between clinical parameters and retinal changes in IH patients. METHODS: Intracranial hypertension patients were divided into eyes with papilledema (IH‐P) and eyes without papilledema (IH‐WP). IH patients underwent lumbar puncture to measure intracranial pressure (ICP); visual acuity was performed using the Snellen chart. Optical coherence tomography (OCT) was used to image and measure the retinal nerve fiber layer (RNFL) and ganglion cell‐inner plexiform layer (GCIPL) while OCT angiography was used to image and measure the superficial vascular complex (SVC) and deep vascular complex (DVC). RESULTS: Intracranial hypertension patients showed reduced microvascular densities and thinner retinal thicknesses compared with the control group (all p < 0.001). Compared with the control group, IH‐P showed reduced microvascular densities and thinner retinal thicknesses (all p < 0.001). IH‐P showed reduced SVC density and thinner retinal thicknesses when compared with IH‐WP (p = 0.008 for SVC, p = 0.025 for RNFL, and p = 0.018 for GCIPL). ICP correlated with the microvascular densities and GCIPL thickness in IH patients (p = 0.025 for GCIPL, p = 0.004 for SVC, and p = 0.002 for DVC). A significant association of ICP with SVC (p = 0.010) and DVC (p = 0.005) densities were also found in IH‐P. CONCLUSIONS: Given the observed differences in these noninvasive retinal imaging markers, further research into their clinical utility in IH is needed.