To investigate the sensitivity of optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) metrics in grading hypertensive retinopathy (HTR) compared with the gold standard color fundus photographs grading of HTR.
Methods: This was a prospective cross-sectional controlled study. Forty-five chronic hypertensive individuals with different grades of HTR were included in groups A, B, and C corresponding to HRT grades I, II, and III according to KWB grading, respectively. Also, 15 healthy volunteers with no history of Hypertension were included in this study (Group D). HTR patients. A 6 × 6-mm macula scan and a 4.5 × 4.5-mm optic nerve head OCTA scan were performed in each patient using a DRI Triton OCT machine. Macular and optic nerve head vessel density (VD), central foveal thickness (CFT), subfoveal choroidal thickness (SCT), and foveal avascular zone (FAZ) area were measured.
Results: The mean CFT was lower in grade I HTR patients (245.167± 22.749), while an increase in thickness in grades II & III (252.800 ± 26.702, 432.467 ± 222.914, respectively) compared to normal controls. Mean SCT was lower in grades I & II and higher in grades III than normal controls. The FAZ area was higher in grades I, II, and III HTN (0.386± 0.131, 0.345± 0.122,0.295±0.077) contrasted to normal controls (p<0.05). Vessel density, skeletonized vessel density of deep and superficial capillary plexus decrease in the various hypertensive groups. No substantial variation in choriocapillaris vessel density across the four groups.The peripapillary capillary density showed a decrease in participants grade I, II compared to normal controls.
Conclusions:The vessel density (VD), skeletonized VD of superficial and deep capillary plexus, FAZ area, peripapillary capillary density significantly degraded in hypertensive patients. The superficial and deep vascular densities are independent risk factors for hypertensive retinopathy and may be used to predict hypertensive retinopathy. Additional prospective longitudinal studies are required to sort out the problem.