Assessment of Juxta Papillary Retinal Fiber Layer in Normal Blood Pressure, Controlled and Uncontrolled Hypertensive Patients

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Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Renal vascular damage resulting from hypertension (HTN) is referred to as hypertensive retinopathy (HR). Generally, symptoms manifest later in the illness. Changes in the vascular wall, arteriovenous nicking, arteriolar constriction, flame-shaped hemorrhages, yellow hard exudates, cotton-wool spots, and optic disk edema are seen in the funduscopic examination. Aim: To investigate alterations in the juxta papillary retinal nerve fiber layer (RNFL) in cases with uncontrolled systemic HTN compared to controlled systemic HTN and normotensive eyes utilizing Spectral Domain Optical Coherence Tomography (SD-OCT). Patients and Methods: A twelve-month cross-sectional trial was conducted on cases with localized defects in RNFL and normal subjects. Sixty eyes were enrolled and divided into three groups: the first group included 20 eyes with uncontrolled systemic HTN patients, the second group included 20 eyes with controlled systemic HTN patients, and the third group included 20 eyes with normal blood pressure (BP). Results: The total macular volume (TMV) showed the most significant diagnostic performance and features in distinguishing uncontrolled HTN from managed HTN. Regarding distinguishing managed HTN from normal BP, the TMV showed the most excellent diagnostic performance and features. Conclusion: Significant reductions in the thickness of RNFL and macula were seen in cases with uncontrolled systemic HTN compared to those with managed systemic HTN and normotensive eyes. This investigation validated the significance of OCT in HR monitoring.

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