Statement of Retraction: lncNALT knockdown ameliorates hypertensive retinopathy via PTEN/PI3K/AKT pathway

Funding Acknowledgements Type of funding sources: None. Introduction Control of cardiovascular risk factors is the cornerstone of secondary prevention. However, in patients with retinopathy of vascular etiology (hypertensive, diabetic or atherosclerotic) the benefit of stricter control of lipid in the long term has been little studied. Methods Prospective study of a cohort of 107 patients who underwent fundus and coronary angiography, of which 42 (39.3%) required percutaneous revascularization. During the follow-up, new cardiovascular events and analytical control of cardiovascular risk factors were recorded. Results Mean age was 75.19 ± 11.53 years. 60.7% were men, 78.5% were hypertensive, 32.7% were diabetic, and dyslipidemia was observed in 57%. Initially, 28% had 1-vessel disease, 14% 2-vessel, 8.4% 3-vessel, and 3.8% left common trunk. 0.9% had diabetic retinopathy, 3.7% had hypertensive retinopathy, 1.9% atherosclerotic, 70.1% had a combination of hypertensive and atherosclerotic retinopathy, and 7.5% signs compatible with all types. Initial and final mean values of LDL-c and HDL-c by type of retinopathy are in Table 1. During follow-up, a significant improvement in LDL-c and HDL-c levels was observed in total patients and in patients with hypertensive and atherosclerotic retinopathy, however globally lipid control was poor and only 18.9% of the total of the sample reached the recommended levels for very high-risk people (<55 LDL-C). Advanced hypertensive retinopathy patients with a greater reduction in LDL-C during follow-up, recorded lower mortality (p = 0.004). Besides, patients with previous percutaneous revascularization showed a greater decrease in LDL levels at the end of follow-up (69.5 ± 26.1 vs 103 ± 41.47; p <0.001); without significant changes in the rest of parameters. Conclusions In patients with vascular etiology retinopathy, long-term lipid control is poor. However, patients with hypertensive retinopathy and a greater reduction in LDL-c had lower long-term mortality. Hypertensive retinopathy Initial Final Sig. LDL-Cholesterol (mg / dl) 102,8+/-35,5 75,65+/-28,9 <0,001 HDL-Cholesterol (mg / dl) 42,1+/-10,3 43,46+/-13,1 0,04 Atherosclerotic retinopathy LDL-Cholesterol (mg / dl) 101,2+/-36,8 79,8+/-32,98 <0,001 HDL-Cholesterol (mg / dl) 42,8+/-11,6 45,73+/-13,9 0,03 Diabetic retinopathy LDL-Cholesterol (mg / dl) 89,1+/-35,8 69,8+/-18 0,73 HDL-Cholesterol (mg / dl) 35,2+/-8,7 31,51+/-12,7 0,73

Hypertensive retinopathy reflects systemic microvascular injury and serves as a prognostic marker for cardiovascular risk. Racial disparities in hypertension-related outcomes are well documented, but limited data exist on whether the presence of hypertensive retinopathy confers differential cardiovascular risk across Black and White populations. In this retrospective cohort study using the TriNetX Research Network (2010-2021), we analyzed 4914 propensity score-matched adults (24557 Black and 24557 White) with diagnoses of hypertension and hypertensive retinopathy. Baseline characteristics were balanced across 34 variables. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for major cardiovascular outcomes. Black patients with hypertensive retinopathy had significantly higher rates of all-cause hospitalization (46.4% vs. 43.9%; HR 1.076, 95% CI 1.048-1.105), acute heart failure (10.9% vs. 9.7%; HR 1.125, 95% CI 1.064-1.189), myocardial infarction (5.7% vs. 5.0%; HR 1.139, 95% CI 1.055-1.230), and ischemic stroke (9.7% vs. 7.9%; HR 1.228, 95% CI 1.157-1.304). Atrial fibrillation/flutter was less common in Black patients (8.9% vs. 10.4%; HR 0.848, 95% CI 0.801-0.898). Among patients with hypertensive retinopathy, Black individuals experienced worse cardiovascular outcomes compared to White individuals. These findings highlight the importance of hypertensive retinopathy as a clinical risk marker and emphasize the need for equitable, targeted interventions to mitigate racial disparities in hypertension-related complications.

Hypertensive retinopathy is a common complication in patients with hypertension. This study aims to assess the prevalence, associated factors and awareness of hypertensive retinopathy among an elderly population with hypertension in Bhaktapur, Nepal. This is a population-based, cross-sectional study conducted from 2013 to 2015 in Bhaktapur district, Nepal. The sample size was 2100 subjects aged 60 years and above. From this sample, all diagnosed patients with hypertension were analyzed. A detailed history was obtained, and an ocular examination was performed. Information was complete for 1860 (88.57%) subjects. The age of the study population ranged from 60 to 95 years with the mean age of 69.64±7.31 years. Hypertension was found in 643 subjects (34.61%), of which 224 (12.04%) were newly diagnosed cases. Among the subjects with hypertension, hypertensive retinopathy was found in 81 cases (12.6%). Hypertensive retinopathy was more frequent in the age group 70-79 years (15.23%), males (13.25%), illiterates (13.56%), diabetics (16.49%), and body mass index (BMI) ≥25 kg/m2 (14%). None of the factors was found to be statistically significant. Among the study participants, awareness regarding the effect of hypertension on eye, retina and vision was found to be 13.84%, 8.4%, and 11.98% respectively. Prevalence of hypertension and hypertensive retinopathy among an elderly population of 60 years and above in Bhaktapur district, Nepal were similar to other countries. Hypertensive retinopathy was higher among males, illiterates, diabetes and BMI> 25kg/m2. Awareness of hypertensive retinopathy was 8.4% among hypertensive subjects. Emphasis should be directed toward improving awareness campaigns.

Hypertensive retinopathy and cardiovascular disease risk: 6 population-based cohorts meta-analysis

Background: Hypertensive retinopathy is almost always associated with other target organ damage. Relationship of hypertensive retinopathy with left ventricular hypertrophy (LVH) and proteinuria was inconclusive in previous studies.Objective: To assess the relation between Left Ventricular Hypertrophy and Proteinuria in Hypertensive Patient with Retinopathy in Tertiary Care Hospital.Methods: This is a cross-sectional observational study and conducted at the Department of Medicine and Cardiology in Dhaka Medical College Hospital. Total 100 hypertensive retinopathy patients were included in the study. Following informed written consent, physical examination, relevant investigations were done. In all cases, Ethical issues were maintained properly and collected data were analysed by SPSS 20.Results: Among 100 participants, mean age was 57.15 (±12.989 SD) years [age range 29-85] and 61% were male & 39% were female. Mean value of Systolic (SBP) and Diastolic Blood pressure (DBP) in Grade (G)-1, G-2 and G-3 hypertension were 150.8 (± 5.4) & 94 (± 2.6) mm Hg, 170.3 ± 4.9 & 101.0 ± 4.7 mm Hg and 188.0 ± 7.0 & 102.6 ± 6.5 mm Hg respectively and it is significantly associated with severity of LVH (p value < 0.001 in both SBP & DBP). Proteinuria is also associated with severity of hypertension (p <0.001) but there were no association of Hypertensive retinopathy with LVH and proteinuria (p value 0.32 and 0.27 respectively).Conclusion: LVH & Proteinuria is associated with severity of Hypertension but Hypertensive retinopathy is not associated with LVH and proteinuria, though further large cohort is recommended for final comment.

Hypertensive, diabetic, and mixed retinopathies are prevalent ocular conditions that can serve as indicators of systemic diseases, particularly chronic kidney disease (CKD). The association between the severity of these retinopathies and the grading of CKD remains under-explored. This study aims to elucidate the correlation between the severity of hypertensive, diabetic, or mixed retinopathies and the stages of CKD, providing insights into the interconnected pathophysiology of these conditions. A cross-sectional study was conducted involving 100 patients diagnosed with hypertensive, diabetic, or mixed retinopathies. Participants were categorized based on their retinopathy type and severity using standardized grading systems. CKD staging was determined according to the kidney disease guidelines. Data were collected through comprehensive ophthalmic examinations, retinal imaging's and patient medical histories. Statistical analysis was performed to assess the association between retinopathy severity and CKD stages using odds ratio (OR). The study found a significant positive correlation between the severity of retinopathies and the stages of CKD. Hypertensive Retinopathy with visual morbidity and complications was found to be associated with greater severity of CKD (OR=2.98, P =0.014). Patients with advanced CKD stages had more severe diabetic retinopathy compared to those with lesser severity with OR of 3.60 (P =0.013). Mixed retinopathy had the strongest association with severity of CKD with OR of 9.07; P =0.002). The severity of hypertensive, diabetic, and mixed retinopathies correlates strongly with CKD progression. These findings highlight the need for integrated care models emphasizing regular ophthalmic and renal evaluations in at-risk populations. Early detection and management of retinopathies may facilitate timely intervention for CKD, reducing systemic disease burden.

The purpose of this study was to identify how chronic hypertension (HTN) and hypertensive retinopathy (HTNR) have different effects on retinal damage including inner retinal thinning and microvasculature impairment. The subjects were divided into three groups: controls, HTN patients without HTNR (HTN group), and patients with relieved HTNR (HTNR group). The ganglion cell-inner plexiform layer (GC-IPL) thickness, vessel density (VD), and GC-IPL/VD ratio were compared among the groups. A total of 241 eyes were enrolled; 101 in the control group, 92 in the HTN group, and 48 in the HTNR group. The mean GC-IPL thicknesses were 83.5 ± 5.7, 82.1 ± 6.2, and 75.9 ± 10.7 μm in each group, respectively (P < 0.001). The VD was 20.5 ± 1.3, 19.6 ± 1.4, and 19.5 ± 1.6 mm−1 in each group, respectively (P = 0.001). The GC-IPL/VD ratio was 4.10 ± 0.33, 4.20 ± 0.40, and 3.88 ± 0.56 in each group, respectively (P < 0.001). In the HTNR group, HTN duration (B = 0.054, P = 0.013) and systolic blood pressure (SBP) (B = −0.012, P = 0.004) were significantly associated with the GC-IPL/VD ratio. In conclusion, inner retinal reduction and retinal microvasculature impairment were observed in patients with HTN and HTNR, and the GC-IPL/VD ratio of HTNR patients was significantly lower than that of HTN patients, indicating more prominent damage to the inner retina than microvasculature in HTNR patients. Additionally, the GC-IPL/VD ratio was significantly associated with SBP in HTNR patients, so more strict BP control is required in HTNR patients.

GPR174 suppression attenuates retinopathy in angiotensin II (Ang II)-treated mice by reducing inflammation via PI3K/AKT signaling

Objetivo: Analisar os valores da pressão intra-ocular (PIO) entre diferentes grupos de pacientes (diabéticos, hipertensos com ou sem retinopatia) e a população normal. Métodos: Realizou-se a aferição da pressão intra-ocular (PIO) em um total de 924 olhos de 482 pacientes com idade igual ou maior que 40 anos (x=56,70; dp=11,89) examinados segundo um protocolo de estudo que incluiu medida da PIO, pressão arterial e glicemia, além da fundoscopia. A determinação da PIO foi obtida pelo tonômetro de aplanação de "Goldmann" e a glicemia foi aferida por meio de tiras reativas (Dextrostix -- Bayer). Em seguida, os pacientes foram divididos em 7 (sete) grupos: hipertensos, hipertensos com retinopatia, diabéticos, diabéticos com retinopatia, hipertensos e diabéticos, hipertensos e diabéticos com retinopatia e a população controle. Resultados: Pelo teste de ANOVA-uma via, numa distribuição normal no nível de significância de 5%, observou-se que o valor médio da PIO é significativamente maior no grupo de pacientes hipertensos sem retinopatia (média PIO=16,10), no grupo dos hipertensos com retinopatia (média PIO=16,33) e no grupo de diabéticos e hipertensos com retinopatia retinopatia (média PIO=16,95). Conclusões: Observou-se que o valor médio da PIO é progressivamente mais elevado conforme o tempo de evolução da doença hipertensiva e também quando esta se encontra associada à diabetes mellitus.

ObjectiveTo investigate the association between hypertensive retinopathy (HR) and components of the renin-angiotensin system (RAS), specifically angiotensin II (Ang II) and angiotensin-converting enzyme (ACE), as potential biomarkers for the diagnosis and prognosis of HR.MethodsA total of 90 patients diagnosed primarily with hypertension were prospectively enrolled. HR was graded according to the Keith-Wagener-Barker classification into three severity groups. Paired serum and tear fluid samples were collected from each participant to measure Ang II and ACE levels, assessing both systemic and ocular changes. Statistical analyses included tests for normality and variance, as well as appropriate non-parametric methods. A p-value <0.05 was considered significant.ResultsSerum Ang II levels increased significantly with advancing stages of HR (p=0.039), showing a 42% rise in moderate HR compared to mild HR and an additional 18% increase in severe HR. Tear Ang II levels decreased markedly from mild to moderate HR (p=0.022) and from mild to severe HR (p=0.028). Serum ACE levels rose significantly as HR progressed (p=0.032), notably between mild and moderate HR (66% increase, p=0.009), whereas tear ACE levels showed no significant differences.DiscussionOur findings showed that serum Ang II and ACE levels rise with HR severity, indicating systemic RAS activation, while tear Ang II decreases, suggesting altered local regulation. These contrasting trends reflect tissue-specific RAS activity and support the potential of Ang II as a biomarker for HR progression. The unchanged tear ACE levels imply limited ocular surface involvement. Overall, the data underscore RAS components’ diagnostic relevance and therapeutic potential in hypertensive retinopathy.ConclusionThese findings suggest that Ang II levels in serum (increasing) and tears (decreasing) correlate with HR severity, while ACE changes are significant only in serum. Further studies are warranted to elucidate the role of RAS in HR pathophysiology and to explore its potential as a therapeutic target in ocular disease.

BackgroundThis cross sectional investigation included 12,966 subjects with hypertension, a cohort of the China Stroke Primary Prevention Trial (CSPPT), a randomized, multicenter clinical trial. This study aimed to explore the correlation between serum uric acid (SUA) concentration and hypertensive retinopathy in hypertensive adults.MethodsDiagnosis of hypertensive retinopathy was determined by non-mydriatic fundus photography and classified with Keith-Wagener-Barker (KWB) system. The correlation of SUA levels with hypertensive retinopathy prevalence and severity was assessed by statistical analysis.Results9848 (75.95%) subjects were diagnosed with hypertensive retinopathy with the following retinopathy grade distribution: grade 1: 58.80%, grade 2: 14.81%, and grade 3–4: 2.34%. SUA levels were significantly associated with hypertensive retinopathy prevalence. Patients with hypertensive retinopathy had higher SUA levels than those without hypertensive retinopathy. Patients in the highest uric acid quartile had an odds ratio for hypertensive retinopathy of 1.21 compared to patients in the lowest uric acid quartile (OR = 1.21, 95% CI: 1.05–1.40, P = 0.008). When compared to the non-hyperuricemia group, those in the hyperuricemia group had an odds ratio for hypertensive retinopathy of 1.18(OR = 1.18, 95% CI: 1.05–1.33, P = 0.004). Every 1 mg/dl increase in uric acid concentration was significantly associated with a 6% higher odds of hypertensive retinopathy (OR = 1.06, 95% CI: 1.02–1.10, P = 0.002).ConclusionsThe prevalence of hypertensive retinopathy was high (75.95%) among hypertensives in our patients cohort. In addition, SUA concentration was significantly associated with hypertensive retinopathy.

PurposeWe investigated the association between albuminuria and hypertensive retinopathy (HR) in hypertensive adults.MethodsThis was a cross-sectional subgroup analysis of data from the China Stroke Primary Prevention Trial. We enrolled 2,964 hypertensive adults in this study. Keith-Wagener-Barker stages was used to assess HR. The urinary albumin to creatinine ratio (UACR) was calculated to evaluate albuminuria.ResultsHR was found in 76.6% (n = 2, 271) of the participants, albuminuria was found in 11.1% (n = 330). The UACR levels were significantly higher in subjects with HR than in those without HR (grade 1, β = 1.42, 95% confidence intervals [CI]: -0.12, 2.95, p = 0.070; grade 2, β = 2.62, 95% CI: 0.56, 4.67, p = 0.013; grade 3, β = 5.17, 95% CI: 1.13, 9.20, p = 0.012). In the subgroup analyses, the association between HR and UACR was stronger in current smokers (p for interaction = 0.014). The correlation between HR grades 1 and 2 and UACR was stronger in subjects with higher triglyceride levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglycerides levels (< 1.7 mmol/L, p for interaction = 0.023). The odds of albuminuria were significantly higher in subjects with HR than in those without HR (grade 1, odds ratio [OR] = 1.57, 95% CI: 1.08, 2.29, p = 0.019; grade 2, OR = 2.02, 95% CI: 1.28, 3.18, p = 0.002; grade 3, OR = 2.12, 95% CI: 0.99, 4.55, p = 0.053). In the subgroup analyses, the association between HR grades 1 and 2 and albuminuria was stronger in subjects with higher triglycerides levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglyceride levels (< 1.7 mmol/L, p for interaction = 0.014).ConclusionHR was positively correlated with albuminuria in hypertensive Chinese adults. This correlation was more remarkable when the population was stratified by triglycerides levels and smoking status. HR can be used as an indicator of early renal injury.

Hypertensive retinopathy is a common complication among people with hypertension. The current study assessed the risk stratification on systemic target organ involvement of people with hypertensive retinopathy. In a hospital- based cross-sectional study conducted at a tertiary referral eye institute in Nepal, we included consecutive people ≥ 31 years with essential hypertension. Details of histories and systemic target organ involvements were documented. People with un-gradable retinal findings of hypertensive retinopathy and prior retinal surgery were excluded. All participants underwent comprehensive eye examination, including dilated fundus examination. Hypertensive retinopathy was classified by Modified Scheie classification. Multivariate analysis was performed to identify the risks for hypertensive retinopathy and target organ involvement. The study recruited 312 subjects. The mean age was 63.68 ± 12.63 years. The mean duration of hypertension was 7.0 ± 6.5 years. Hypertensive retinopathy was detected in 83.7% (n=261) people and 63.5% (n= 198) had grade 1 hypertensive retinopathy. Target organ involvement was detected in 20.5% (n =64) people. These included cardiac (12.5%; n=39), central nervous (5.1%; n= 16), and renal (4.5%; n=14) systems. In multivariate analysis, concurrent hyperlipidaemia was significantly associated with hypertensive retinopathy and target organ involvement. Target organ involvement increased with the severity of hypertensive retinopathy. Over four-fifths of people with hypertension had hypertensive retinopathy and one-fifth had other systemic target organ involvements. Severity of hypertensive retinopathy and concurrent hyperlipidaemia were associated with target organ involvement. Hypertensive retinopathy can be considered for risk stratification to other target organ involvement in a clinical setting.

Isolated cerebellar involvement in posterior reversible encephalopathy syndrome

Automatic segmentation of retinal images is an important task in computer-assisted medical image analysis for the diagnosis of diseases such as hypertension, diabetic and hypertensive retinopathy, and arteriosclerosis. Among the diseases, diabetic retinopathy, which is the leading cause of vision detachment, can be diagnosed early through the detection of retinal vessels. The manual detection of these retinal vessels is a time-consuming process that can be automated with the help of artificial intelligence with deep learning. The detection of vessels is difficult due to intensity variation and noise from non-ideal imaging. Although there are deep learning approaches for vessel segmentation, these methods require many trainable parameters, which increase the network complexity. To address these issues, this paper presents a dual-residual-stream-based vessel segmentation network (Vess-Net), which is not as deep as conventional semantic segmentation networks, but provides good segmentation with few trainable parameters and layers. The method takes advantage of artificial intelligence for semantic segmentation to aid the diagnosis of retinopathy. To evaluate the proposed Vess-Net method, experiments were conducted with three publicly available datasets for vessel segmentation: digital retinal images for vessel extraction (DRIVE), the Child Heart Health Study in England (CHASE-DB1), and structured analysis of retina (STARE). Experimental results show that Vess-Net achieved superior performance for all datasets with sensitivity (Se), specificity (Sp), area under the curve (AUC), and accuracy (Acc) of 80.22%, 98.1%, 98.2%, and 96.55% for DRVIE; 82.06%, 98.41%, 98.0%, and 97.26% for CHASE-DB1; and 85.26%, 97.91%, 98.83%, and 96.97% for STARE dataset.