Optical coherence tomography angiography and arterial hypertension: A role in identifying early vascular damage?

Session Details

Session Title: Free Paper Session 17: Imaging II

Session Date/Time: Saturday 09/09/2017 | 08:00-09:30

Paper Time: 08:54

Venue: Room 120

First Author: : S.Donati ITALY

Co Author(s): :    A. Maresca   S. Caprani   J. Cattaneo   A. Grossi   M. Mazzola   L. Guasti   C. Azzolini           

Abstract Details

Purpose:

Optical coherence tomography angiography (OCT-A) is a novel, non-invasive OCT technique able to identify and characterize retinal vasculature patterns. This study aims to evaluate the retinal microvasculature modifications in human subjects first diagnosed for arterial hypertension and to assess potential clinical applications on early diagnosis.

Setting:

Patients followed by the Outpatient Clinic for Hypertension, University of Insubria of Varese, Italy and examined by the Retina centre, Ophthalmology Clinic of the same University.

Methods:

Cross-sectional study of 35 subjects affected by arterial hypertension compared to a matched cohort of healthy patients. We divided patients into 3 groups: Group 1 healthy patients, Groups 2 patients with mild hypertension and Group 3 patients with severe hypertension. OCT-A was performed applying different analysis protocols for macula and optic disk, using SD-OCT-A Avanti Optovue by SSADA algorithm. OCT angiograms were studied with corresponding OCT B scans and retinal maps, to assess accuracy and clinical utility. Morphological data were compared and correlated to vascular function parameters as central and office blood pressure, microalbuminuria to evaluate the predictive value of OCT analysis.

Results:

Morphological data of retinal superficial and deep plexa showed interesting differences between healthy and hypertensive patients. In particular a significative reduction of deep vascular layer (Group 1: 59,2±1,5%; Group 2: 59,2±2.2%; Group 3: 57,8±2,6%) as well as an enlargement of deep foveal avascular zone area (Group 1: 0,34±0,09mm2; Group 2: 0,36±0,07 mm2; Group 3: 0,39±0,1 mm2) appeared in patients with mild hypertension and in chronic pathology compared to healthy patients (p0.05). We observed as well a significative decrease of mean foveal choroidal thickness related to the presence of the pathology (Group 1: 319,68±61,72mm; Group 2: 251,04±63,1mm; Group 3: 262,65±51,08mm; p0.05). Our preliminary data didn’t show a significant correlation with other functional parameters (microalbuminuria).

Conclusions:

This pilot study showed anatomical modification of retinal vasculature in hypertensive patients vs healthy patients. These data represent at now a preliminary evaluation due in particular to the limitation of the cohort, but we think it is worth to keep on this way to study retinal features by OCT-A. Progress on this imaging modality may identify early pathological damages and/or their progression with undoubted therapeutic advantages.

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