Optical coherence tomography angiography findings in hypertensive patients

Purpose This study was designed to assess the macular retinal and choroidal microvascular abnormalities in hypertensive patients with hypertensive retinopathy using optical coherence tomography angiography (OCT-A). Patients and methods This is a prospective cross-sectional study that was conducted on 60 eyes of 60 hypertensive patients diagnosed with hypertensive retinopathy and 20 eyes of 20 normal healthy controls. Swept source optical coherence tomography was performed to assess the retinal and choroidal thickness in the foveal, parafoveal, and perifoveal areas in the different quadrants. In addition, swept source optical coherence tomography angiography was performed to assess the foveal avascular zone in the superficial and deep retinal capillary plexus levels using 3×3 mm scan, and to assess the vascular density index in the superficial and deep retinal capillary plexus, along with choriocapillaris levels using 3×3 mm and 6×6 mm scans. Results The hypertensive patients showed statistically significantly lower choroid thickness and volume compared to the control group in all quadrants ( P <0.001). A significant enlargement of the foveal avascular zone was observed in hypertensive group in the superficial and deep retinal plexus levels ( P <0.001). The vascular density index in all retinal layers (superficial, deep retinal capillary plexus, and choriocapillaris levels) was significantly lower in the hypertensive group compared to the control group ( P <0.001). Conclusion Lower vascular perfusion was detected in the hypertensive patients in the superficial and deep retinal capillary plexus levels, along with the choriocapillaris level.