The Characteristics Of Macular Retinal Microvascular Flows In Patients With Hypertension And Its Influencing Factors

Objective: Using Optical Coherence Tomography Angiography(OCTA)to investigate the characteristics of retinal microvascular flow in patients with hypertension.Aim to analyze the relationship between retinal microvascular flow and systemic risk factors of hypertension.Methods: This study is a cross-sectional study.The objects of this study were clinically diagnosed as hypertension(systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg)who were hospitalized in the Hypertension Center of the first hospital of China medical university from September 2020 to June 2021.All patients underwent blood pressure,transthoracic echocardiography,bilateral carotid Doppler ultrasound,serological and biochemical tests,intraocular pressure,fundus photography,and OCTA examination to get images of retinal capillary layer.Using Image J software to process the images to obtain retinal capillary blood flow characteristics,including the Foveal avascular zone(FAZ)area mean vessel density of superficial retinal capillary plexus(SCP)and deep rentinal capillary plexus(DCP).Using univariate and multivariate regression analyses to evaluate the relationship between the characteristics and systemic risk factors related to hypertension.Results: Ninety-six patients(96 eyes)were included in this study,including 54 male patients(54 eyes)and 42 female patients(42 eyes).The mean age was 45.72±13.67 years,the mean systolic blood pressure was 147.60±19.36 mm Hg,and the mean diastolic blood pressure was 91.14±14.38 mm Hg.In the linear regression analysis of macular capillary density and blood pressure,there was a linear relationship between DCP vessel density(β=-0.036 95%CI[-0.069-0.003],P=0.032)and systolic blood pressure.There was a linear relationship between SCP vessel density and systolic blood pressure(β=-0.02795%CI[-0.053-0.000],P=0.047).In a univariate simple linear regression of macular retinal capillary density,Volume density of blood vessels and ipsilateral common carotid artery diameter(beta = 0.776,95% CI(1.411,0.140],P = 0.017)and pulmonary artery diameter(beta = 0.316,95% CI(0.587,0.046],P = 0.023)there is a linear relationship between;SCP vessel density and ipsilateral common carotid artery diameter(β=-0.639,95%CI[-1.172--0.107],P=0.019)),pulmonary artery diameter(beta = 0.282,95% CI(0.499,0.065],P = 0.011),the ascending aorta diameter(beta = 0.208,95% CI(0.347,0.068],P = 0.004))and age(beta = 0.042,95% CI(0.079,0.004],P = 0.029)are linear relationship between;All were negatively correlated.In the linear regression analysis of FAZ area and blood pressure,there was a linear relationship between FAZ area of DCP and systolic blood pressure(β=0.002 95%CI[0.001-0.003],P=0.004).There was a linear relationship between FAZ area of SCP(β=0.002 95%CI[0.001-0.003],P=0.001)and systolic blood pressure.In the simple linear regression analysis between FAZ area and serological indicators,there was a linear relationship between FAZ area of DCP(β=0.033,95%CI[0.007-0.060],P=0.014)and serum total cholesterol level.There was a linear relationship between the FAZ area of SCP(β=0.033,95%CI[0.006-0.061],P=0.019)and TC.In the multiple regression adjusted for age,DCP vessel density was negatively correlated with systolic blood pressure(β=-0.044,95%CI [-0.082--0.006],P=0.025)and age(β=-0.078,95%CI [-0.136--0.020],P=0.009).The FAZ area of DCP was positively correlated with systolic blood pressure(β=0.001,95%CI [0.000-0.003],P=0.007)and serum total cholesterol level(β=0.062,95%CI [0.014-0.110],P=0.012),the difference was statistically significant.Conclusions:(1)There is a relationship between the changes of retinal capillary blood flow in the macular area and the risk factors of cardiovascular diseases related to hypertension.(2)There was a correlation between systolic blood pressure and macular capillary density and FAZ area in hypertensive patients.(3)There was a negative correlation between the capillary density of retinal in macular area and the internal diameter of large blood vessels in hypertensive patients.(4)Serum total cholesterol level was positively correlated with FAZ area of DCP in hypertensive patients.