Abstract
In recent years, the study of the structural and functional state of the retina in patients with the hypertension stage of the I-IInd type with the usage of optical coherence tomography with angiography, is the subject of particular interest. It was examined 54 patients with the I- II stage of hypertension, aged 35 to 62 years, who did not receive antihypertensive therapy. Visualization of retinal structures was performed using an optical coherence tomograph (RTVue XR Avanti OCTA (Optovue, Inc, with AngioVue Software 2.0) with angiography function. A decrease in visual acuity was found in 56.67% of patients with hypertension of the I stage, and – in 79.17% of patients with the II stage. From the retinal arterioles it was detected an increase in their tone, especially among patients with hypertension of the II stage. On the part of capillaries, among patients of the main group, their tortuosity was noted – in 62.5% of patients with the II stage of AH, also in 54.17% of cases it was revealed a granular blood flow. Also among this group of patients, microaneurysms were revealed in a third of patients, areas of depletion were revealed in 41.67% of patients. Among extravascular disorders, in patients with I-II degree AH, were revealed hemorrhages, retinal edema, thickening of the neuroepithelium and pleximorphic layer, smoothing of the foveolar fossa, edema of the macular area, also it was detected accumulation of fluid between the layers. The study of the peripapillary zone of the retina revealed a significant thickening of the layer of nerve fibers in patients with the I stage of AH up to (176.4 ± 9,75) μm in 33.33% of people, under the II stage – to (190,24 ± 12,53) μm, in 54.17% of cases, against the index rules – (10 2.5 ± 6, 47) μm. In 12.5% of cases, the RNFL index was significantly lower than the obtained norm – (93.78 ± 6.19) μm. Currently, it is necessary to continue the study of the retina in patients with hypertension to determine the risks of damage caused to target organs and evaluate the effectiveness of prescribed antihypertensive therapy.
Highlights
Arterial hypertention is one of the leading problems of modern medicine, due to the wide spread of the disease among the population, and the place that it occupies in the structure of mortality and growth of disability.The nature of the vascular bed changes – from the main blood vessels to the capillaries at the arterial hypertension (AH) shows the clinical course of the disease, the effectiveness of antihypertensive therapy designed, and the risks of possible complications.Stress integral formation of hypertension accompanied by mental disintegration, and neurohormonal somatovegetativnyh processes, with the entire range of stress-realizing and stress-limiting effects occur at the level of microcirculatory (ICR), cellular metabolism (Park, 2016:36; Forouzanfar, 2017:2)
AH was revealed in 30 patients, men and women – 12 and 18, respectively; 24 people were diagnosed with II st
There is no consensus on the need for retinal examination in patients with hypertension to determine the degree of cardiovascular risk and assess the effectiveness of prescribed antihypertensive therapy
Summary
Stress integral formation of hypertension accompanied by mental disintegration, and neurohormonal somatovegetativnyh processes, with the entire range of stress-realizing and stress-limiting effects occur at the level of microcirculatory (ICR), cellular metabolism (Park, 2016:36; Forouzanfar, 2017:2). This disturbance in microcirculatory line subtly reflects changes in hemodynamics, but the system homeostasis in general, the development of compensatory or pathological reactions (Khaisheva, 2013:49; Hoppe, 2007: 25). Of particular interest are studies of the retina as part of the "exposed" brain in patients with hypertension From this perspective it is assumed that the processes that occur in the blood vessels and nerve ganglia retina is the reflection process along certain areas of the brain. Explore spare condition in the retina – changes of its structures and functions at the background of hypertension, a condition of its blood supply, will indirectly give the understanding of the features of intracranial blood flow in the basin a. ophthalmica, branches of the anterior and middle cerebral arteries, and it is possible to detect certain functional changes in these parts of the brain at the background of a permanent increase of blood pressure
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