Связь парацентральной острой срединной макулопатии и гипертонической болезни

Abstract

Purpose. To study changes in retinal microcirculation and the prevalence of chronic paracentral acute middle maculopathy (PAMM) lesions in patients with mild hypertension. Participants. Twenty-seven patients (21 males and 6 females 50.3 ± 6.3 years) with mild hypertension without cardiovascular risk and 24 healthy subjects (15 males and 9 females, 46.3 ± 13.0 years) were included. Methods. The foveal avascular zone (FAZ) area, vessel density of superficial and deep capillary plexus were assessed using optical coherence tomography (OCT) angiography. The presence of chronic PAMM lesions was evaluated by the revision of cross-sectional OCT images of 6-mm volume scans. A chronic or resolved PAMM lesion was defined as inner nuclear layer thinning with outer plexiform layer disruption. Results. There was no difference between hypertensive and healthy group in baseline characteristics, vessel density of superficial capillary plexus, vessel density of deep capillary plexus and FAZ area. Chronic PAMM lesions were found in 88.9 % hypertensive patients and in 16.7 % healthy individuals. The odds ratio for the presence of chronic PAMM lesions in mild hypertension was 40.0 (p < 0.001). Conclusion. Chronic PAMM lesions are highly prevalent in hypertensive patients and may represent the earliest changes in retinal microcirculation in mild hypertension, before changes in OCT angiography parameters have become apparent. Keywords: paracentral acute middle maculopathy, hypertension, optical coherence tomography