Evaluating the effect of systemic hypertension on retinal, optic nerve head microvasculature and field of vision using optical coherence tomography angiography and visual field analyzer

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Abstract
To assess the effect of systemic hypertension on retinal and peripapillary vascular density and visual field (VF) deviation. This prospective observational case-control study included 136 eyes, 68 eyes of 34 patients with hypertension (HTN), and 68 eyes of 34 healthy controls. HTN patients: group 1: ≤5 years HTN duration was less than 5years and group 2: HTN > 5 years. All participants were assessed using OCTA quantitative (vessel density (VD), foveal avascular zone (FAZ) area, superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC), radial peripapillary capillaries (RPC)) and 24 − 2 glaucoma hemifield tests. The results were recorded and analyzed. Macula OCTA revealed a reduction in foveal and total VD in the SCP and DCP in HTN groups 1 and 2. There was a reduction in the inferior CC layer in the HTN group2, enlarged FAZ area and perimeter were demonstrated with reduced circularity. in DCP in HTN. Humphrey visual field (HFA) testing in HTN group 1 and 2. revealed that visual field defects occurred more often in group 2 patients with longer HTN duration than in group 1 and controls. The association between the duration of systemic hypertension and the diminution in vessel density, VF deviation, and defects justifies the verification of longitudinal studies. OCTA and visual field examinations are tools for monitoring systemic hypertension.

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