Longitudinal changes in peripapillary retinal nerve fiber layer thickness in hypertension

Abstract

AbstractPurposeTo determine longitudinal changes in the peripapillary retinal nerve fiber layer (pRNFL) thickness in patients with hypertension (HTN).DesignA prospective observational study.ParticipantsParticipants without any ophthalmic disease were divided into two groups: a HTN group (50 eyes) that included patients with HTN for ≥5 years and a control group.MethodsAfter the initial visit, pRNFL thicknesses were measured four more times at 1‐year intervals using spectral‐domain optical coherence tomography. The pRNFL thickness was fitted using linear mixed models. Univariate and multivariate generalized linear mixed models were used to determine factors associated with pRNFL reductions over time.Main Outcome MeasuresThe pRNFL thickness and rate of pRNFL thickness reduction.ResultsThe mean ages of the HTN and control groups were 62.9 ± 6.2 and 60.7 ± 6.1 years, respectively, and they were not significantly different (P = 0.089). The baseline mean pRNFL thicknesses were 90.50 ± 8.31 and 93.90 ± 8.77 μm; they were significantly different (P = 0.049). The mean pRNFL reduction rate was −1.14 and −0.40 μm/year in the HTN and control groups, respectively; the interaction between group and duration was significant (P < 0.001). In the HTN group, all sectors showed a significant reduction over time, but in the control group, only the superior sector showed a significant reduction over time. In the linear mixed model determination of factors associated with pRNFL reduction, there was no significant factor in the control group. In the HTN group, age, and axial length showed significant results in both univariate and multivariate analyses (estimate: −0.43 and −3.59; P = 0.016 and 0.005, respectively).ConclusionsPatients with HTN had a significantly greater decrease in pRNFL than normal individuals. Additionally, age and axial length significantly affected the reduction in pRNFL in HTN patients.