Abstract
Objective: Multiple studies have compared various optical coherence tomography angiography (OCTA) parameters in participants with systemic hypertension vs. controls and have presented discordant findings. We conducted a meta-analysis to pool together data from different studies to generate an overall effect size and find out whether OCTA parameter(s) significantly differed in participants with systemic hypertension as compared to controls.Methods: We conducted a literature search through a search of electronic databases to identify studies before 19 June 2021, which compared OCTA parameters in non-diabetic participants with systemic hypertension vs. controls. If the OCTA parameter had a minimum number of 3 studies that analyzed it, the mean difference between participants with systemic hypertension and controls were analyzed using a random-effects model.Results: We identified 11 eligible studies. At the macula, 9 studies analyzed vessel density at the superficial capillary plexus (SVD), 7 analyzed vessel density at the deep capillary plexus (DVD), and 6 analyzed the area of the superficial foveal avascular zone (FAZ). Participants with systemic hypertension had significantly lower SVD (standardized mean difference [SMD], −0.50 [−0.70, −0.30], P < 0.00001, I2 = 63%), lower DVD (SMD, −0.38 [−0.64, −0.13], P = 0.004, I2 = 67%) and larger superficial FAZ (SMD, 0.32 [0.04, 0.61], P = 0.020, I2 = 77%).Conclusion: The eyes of people with systemic hypertension have robustly lower superficial and deep vascular densities at the macula when compared to control eyes. Our results suggest that OCTA can provide information about pre-clinical microvascular changes from systemic hypertension.
Highlights
Systemic hypertension remains the leading contributor to the global burden of disease and global all-cause mortality, leading to 9.4 million deaths and 212 million lost healthy life years (8.5% of the global total) each year (1)
Damages the body’s microvasculature, and leads to increased risk of complications known as target end-organ damage (Chua J), which include cerebrovascular accidents, cardiovascular diseases, renal failure, and retinal vascular disease
The keywords searched for the concept optical coherence tomography angiography (OCTA) are (1) OCTA; (2) Optical Coherence Tomography Angiography (3) OCT Angiography
Summary
Systemic hypertension remains the leading contributor to the global burden of disease and global all-cause mortality, leading to 9.4 million deaths and 212 million lost healthy life years (8.5% of the global total) each year (1). The retina is a highly vascularized tissue which is susceptible to microvascular damage due to hypertension and retinal imaging provides a unique opportunity to non-invasively assess these pathological changes. The current systems of grading hypertensive retinopathy, the Keith-Wagner-Barker or WongMitchell classification systems, are based on a clinician’s subjective assessment of retinal fundus photographs (3). Signs assessed from retinal fundus photographs (e.g., arteriolar narrowing, arteriovenous nicking, hemorrhages) are limited to the visible larger arterioles and venules in the more superficial layers of the retinal circulation and earlier microvascular changes which may be subclinical biomarkers of disease may be missed (Figure 1)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
