Retinal and Choroidal Changes in Patients with Systemic Arterial Hypertension

Aims: To evaluate retinal and choroidal changes in patients with systemic arterial hypertension using optical coherence tomography (OCT).

Setting: The study was performed in the outpatient clinic of Tanta ophthalmology Hospital.

Design: Prospective, cross sectional and controlled study.

Patients and Methods: Retinal and choroidal changes using spectral domain optical coherence tomography that includes the following parameters: central macular thickness (CMT), Subfoveal choroidal thickness (SFCT), and Retinal nerve fiber layer thickness (RNFL).

Results: The study comprised 10 eyes of healthy individuals without hypertension, 15 eyes of systemic hypertensive patients on beta blockers for more than one year, and 15 eyes of systemic hypertensive patients on calcium channel blockers for more than one year. This study showed There were statistically significant differences between the three studied groups as regards the mean central macular thickness (CMT). In this study, we found a statistically significant decrease in the mean subfoveal choroidal thickness (SFCT) from 247.40 ± 46.18 µm in group A (non hypertensive) to 195.63 ± 28.96 µm in group B (hypertensive patients on beta blockers for more than one year) and decreased to 203.10 ± 27.74 µm in group C (hypertensive patients on calcium channel blockers for more than one year). According to the retinal nerve fiber layer thickness (RNFL), our study showed (100%) were within normal thickness in group A (non-hypertensive), In group B (hypertensive patients on beta blockers for more than one year) Twelve eyes (40.0%) were within normal thickness, ten eyes (33.3%) had thinning inferior, and eight eyes (26.7%) had thinning superior. Eight eyes (26.7%) were within normal thickness, ten eyes (33.3%) had thinning inferior, four eyes (13.3%) had thinning superior, and eight eyes (26.7%) were borderline in group C (hypertensive patients on calcium channel blockers for more than one year).

Conclusion: Hypertension (HTN) has significant increase in the central macular thickness , lower SFCT and thinning in retinal nerve fiber layer thickness in all quadrants compared to normotensive individuals. Neither beta blockers nor calcium channels blockers have significant changes on these previous parameters changes.