Abstract
Purpose: To investigate the Foveal Avascular Zone (FAZ) area in patients with arterial hypertension using optical coherence tomography angiography (OCT-A).Material and methods: The study was permormed at the School Clinic of UNIFACISA and at the Eye Care Center. It was included 21 hypertensive patients (study group) and 19 individuals without hypertension (control group). It was excluded patientes with diabetes or glaucoma. The measurement of the FAZ areas was performed by the DRI OCT-1Triton/Plus. For the quantitative variables, the results were expressed by their means and standard deviations. Qualitative variables were expressed by their absolute and relative frequencies. Student’s t-test was used to verify differences between means and Fisher’s exact test for differences between frequencies. For evaluating the correlation between the superficial and deep plexus areas, the Pearson correlation test was used. P value ≤ 0.05, rejected the null hypothesis. The research was approved by the Ethics Committee of the Medical School from Campina Grande -UNIFACISA and all individuals signed the free and informed consent form.Results: The means of the superficial FAZ of both eyes was significantly higher in the study group (right eye 410.7 ± 160.7 μm2 - 319.1 ± 108.2 μm2 - p = 0.0433); (left eye: 405.4 ± 144.8 μm2 versus 309.4 ± 87.7 μm2- p = 0.0174). The means of the deep FAZ areas of the right and left eyes were similar between the study and control groups (right eye: 559.6 ± 253.28 μm2 versus 605.1 ± 226.8 μm2 - p = 0.5548); (left eye: 673.2 ± 170.8 μm2 versus 585.6 ± 171.2 μm2 - p = 0.1142). The relationships between the superficial and deep plexus areas of both eyes showed a weak correlation between the two plexuses. (r = 0.4734), left eye (r = 0.2287), study group - right eye: (r = 0.4374), left eye (r = 0.3580).Conclusion: The area of superficial FAZ of the right and left eyes was significantly higher in the hypertensive patients. The deep FAZ area of both eyes, however showed similar mean areas between the study and control groups.
Highlights
In Brazil, the prevalence of arterial hypertension varies according to the studied population and the measurement method, reaching about 36 million adult individuals [1,2].The retina microvasculature, choroid and optic disc undergoes patho-physiological alterations secondary to hypertension, whose main representation is by hypertensive retinopathy [3]
The individuals, initially, underwent acomprehensive ophthalmologic examination, biomicroscopy, fundoscopy and intraocular pressure (IOP) measurement. They were submitted to optical coherence tomography angiography (OCT-A), using 3×3 mm digitized images of Topcon’s DRT OCT-1Triton/Plus device, whose software allows the manual measurement of areas to be studied, as the foveal avascular zone (FAZ) area measured in this investigation
It was observed that the mean area of the right FAZ eye was significantly greater in the study group when compared to the control group (410.7 ± 160.7 μm2 - 319.1 ± 108.2 μm2 - p = 0.0433)
Summary
In Brazil, the prevalence of arterial hypertension varies according to the studied population and the measurement method, reaching about 36 million adult individuals [1,2].The retina microvasculature, choroid and optic disc undergoes patho-physiological alterations secondary to hypertension, whose main representation is by hypertensive retinopathy [3]. Since its arterial circulation is similar to cerebral, its evaluation (through fundoscopy, fluorescence angiography and color retinography) is useful and sensitive with regard to the stratification of cardiovascular risk in hypertensive patients [4,5]. The foveal avascular zone (FAZ) is a structure sensitive to retinal microvasculature disorders, and may indicate events of ischemic nature [4,5,6,7,8,9,10,11,12]. The imaging gold standard investigation of the retina vascularization is fluorescein angiography, but it is limited in the depth of analyzed structures, viewing only the superficial vascular plexus [13,14]
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