The Benefits of 24-h Ambulatory Blood Pressure Monitoring in Retinal Small Vessels

Arterial hypertension causes structural and functional alterations to the small vessels of several target organs, including the retina. Although the effect of diurnal blood pressure (BP) on the vascular network of the eye has been investigated, few data exist that highlight the role of nocturnal hypertension in this process. This review summarizes associations between elevated BP and biomarkers or conditions of retinal microvascular damage. It further analyzes the damage pattern observed due to elevated BP and compares the effect of diurnal versus nocturnal BP, including the dipping status. Finally, it demonstrates the potential of retinal small vessel damage as a predictor for injury to other target organs. Nocturnal hypertension seems to have an important role in the remodeling of the vascular network of the eye, and its record via ambulatory BP monitoring may be a useful indicator to predict future alterations on the retinal microvasculature. Nevertheless, further studies are warranted to verify these results and to provide mechanistic insights into the observed associations.