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Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy

PURPOSE: Hypertensive crisis causes end-organ damage through small-vessel damage as described histologically. Noninvasive optical coherence tomography angiography (OCTA) makes it possible to image retinal and choroidal capillaries on a microscopic level in vivo. We quantified eye vessel perfusion ch...

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Autores principales: Terheyden, Jan Henrik, Wintergerst, Maximilian W. M., Pizarro, Carmen, Pfau, Maximilian, Turski, Gabrielle N., Holz, Frank G., Finger, Robert P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Association for Research in Vision and Ophthalmology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422770/
https://www.ncbi.nlm.nih.gov/pubmed/32855888
http://dx.doi.org/10.1167/tvst.9.8.42
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author Terheyden, Jan Henrik
Wintergerst, Maximilian W. M.
Pizarro, Carmen
Pfau, Maximilian
Turski, Gabrielle N.
Holz, Frank G.
Finger, Robert P.
author_facet Terheyden, Jan Henrik
Wintergerst, Maximilian W. M.
Pizarro, Carmen
Pfau, Maximilian
Turski, Gabrielle N.
Holz, Frank G.
Finger, Robert P.
author_sort Terheyden, Jan Henrik
collection PubMed
description PURPOSE: Hypertensive crisis causes end-organ damage through small-vessel damage as described histologically. Noninvasive optical coherence tomography angiography (OCTA) makes it possible to image retinal and choroidal capillaries on a microscopic level in vivo. We quantified eye vessel perfusion changes in hypertensive crisis using OCTA. METHODS: Patients with hypertensive crisis (systolic blood pressure ≥180 mm Hg and/or diastolic blood pressure ≥110 mm Hg) and age-matched healthy controls were included in the study. OCTA en face 3 × 3-mm images of the superficial and deep retinal layers and the choriocapillaris were acquired. Outcome parameters included vessel density (VD) and vessel skeleton density (VSD) of the superficial and deep retinal layers, as well as flow voids of the choriocapillaris. RESULTS: Twenty-eight eyes of 17 patients and 31 age-matched control eyes of 18 healthy subjects were included. VD and VSD of the deep retinal layer were significantly reduced in hypertensive crisis (P ≤ 0.004). Choriocapillaris signal intensity was more heterogeneous in patients, and flow voids exhibited confluence with a larger average area and a lower absolute count (P ≤ 0.045). These changes were independent of time since onset of hypertensive crisis and of the presence and extent of retinopathy. Deep retinal changes were associated with renal end-organ failure (P = 0.045). CONCLUSIONS: Hypertensive crisis is associated with a significant reduction in retinal and choroidal capillary perfusion based on OCTA findings. These alterations are independent of retinopathy and related to end-organ damage. TRANSLATIONAL RELEVANCE: OCTA might help distinguish hypertensive urgency from hypertensive emergency earlier than currently possible.
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spelling pubmed-74227702020-08-26 Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy Terheyden, Jan Henrik Wintergerst, Maximilian W. M. Pizarro, Carmen Pfau, Maximilian Turski, Gabrielle N. Holz, Frank G. Finger, Robert P. Transl Vis Sci Technol Article PURPOSE: Hypertensive crisis causes end-organ damage through small-vessel damage as described histologically. Noninvasive optical coherence tomography angiography (OCTA) makes it possible to image retinal and choroidal capillaries on a microscopic level in vivo. We quantified eye vessel perfusion changes in hypertensive crisis using OCTA. METHODS: Patients with hypertensive crisis (systolic blood pressure ≥180 mm Hg and/or diastolic blood pressure ≥110 mm Hg) and age-matched healthy controls were included in the study. OCTA en face 3 × 3-mm images of the superficial and deep retinal layers and the choriocapillaris were acquired. Outcome parameters included vessel density (VD) and vessel skeleton density (VSD) of the superficial and deep retinal layers, as well as flow voids of the choriocapillaris. RESULTS: Twenty-eight eyes of 17 patients and 31 age-matched control eyes of 18 healthy subjects were included. VD and VSD of the deep retinal layer were significantly reduced in hypertensive crisis (P ≤ 0.004). Choriocapillaris signal intensity was more heterogeneous in patients, and flow voids exhibited confluence with a larger average area and a lower absolute count (P ≤ 0.045). These changes were independent of time since onset of hypertensive crisis and of the presence and extent of retinopathy. Deep retinal changes were associated with renal end-organ failure (P = 0.045). CONCLUSIONS: Hypertensive crisis is associated with a significant reduction in retinal and choroidal capillary perfusion based on OCTA findings. These alterations are independent of retinopathy and related to end-organ damage. TRANSLATIONAL RELEVANCE: OCTA might help distinguish hypertensive urgency from hypertensive emergency earlier than currently possible. The Association for Research in Vision and Ophthalmology 2020-07-29 /pmc/articles/PMC7422770/ /pubmed/32855888 http://dx.doi.org/10.1167/tvst.9.8.42 Text en Copyright 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Article
Terheyden, Jan Henrik
Wintergerst, Maximilian W. M.
Pizarro, Carmen
Pfau, Maximilian
Turski, Gabrielle N.
Holz, Frank G.
Finger, Robert P.
Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy
title Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy
title_full Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy
title_fullStr Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy
title_full_unstemmed Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy
title_short Retinal and Choroidal Capillary Perfusion Are Reduced in Hypertensive Crisis Irrespective of Retinopathy
title_sort retinal and choroidal capillary perfusion are reduced in hypertensive crisis irrespective of retinopathy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422770/
https://www.ncbi.nlm.nih.gov/pubmed/32855888
http://dx.doi.org/10.1167/tvst.9.8.42
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