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Erschienen in: International Ophthalmology 7/2023

10.01.2023 | Original Paper

Evaluation of subclinical changes in recently diagnosed pediatric hypertension patients without hypertensive retinopathy: an OCT study

verfasst von: Yusuf Ziya Güven, Fahrettin Akay, Berkay Akmaz, Emine Nursel Akmaz, Çınar Özen

Erschienen in: International Ophthalmology | Ausgabe 7/2023

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Abstract

Purpose

To investigate subclinical choroidal and retinal changes in recently diagnosed pediatric hypertension (HT) patients.

Methods

This prospective case–control study consisted of 62 treatment naive HT patients (34 essential HT and 28 renal-induced HT) and 62 control subjects aged 10–16 years. All demographic data and ocular parameters were noted. Macula and choroid measurements were acquired by spectral domain optical coherence tomography (SD-OCT). Choroidal measurements were obtained by taking the mean of the measurements taken from 3 nasal and 3 temporal locations at 500µ intervals (mean nasal, mean temporal) in addition to the subfoveal area.

Results

All choroidal thickness (ChT) values in HT subjects were significantly lower than in the healthy group (p < 0.001 for all). Also, there was no statistically significant difference between central macular thickness (CMT) and mean macular thickness (MMT) between the two groups. Subfoveal ChT, mean ChT, and CMT values were statistically lower in patients with renal-induced HT compared to essential HT subjects (p < 0.001, p = 0.04, p = 0.014, respectively). No significant correlation was observed between choroidal thicknesses and blood pressure values in essential and renal HT groups except weak correlation between mean temporal ChT and systolic blood pressure (SBP) in renal HT group (r =  − 0.464, p= 0.013).

Conclusion

This study demonstrated that choroidal thickness decreased even during the subclinical period in treatment naive pediatric HT subjects. In addition, it has been shown that the choroid is more affected in renal-induced HT compared to essential HT group.
Literatur
1.
Zurück zum Zitat Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K et al (2019) Global prevalence of hypertension in children: a systematic review and meta-analysis. JAMA Pediatr 173(12):1154–1163CrossRefPubMedPubMedCentral Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K et al (2019) Global prevalence of hypertension in children: a systematic review and meta-analysis. JAMA Pediatr 173(12):1154–1163CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Yang L, Kelishadi R, Hong YM, Khadilkar A, Nawarycz T, Krzywińska-Wiewiorowska M et al (2019) Impact of the 2017 American academy of pediatrics guideline on hypertension prevalence compared with the fourth report in an international cohort. Hypertension 74(6):1343–1348CrossRefPubMed Yang L, Kelishadi R, Hong YM, Khadilkar A, Nawarycz T, Krzywińska-Wiewiorowska M et al (2019) Impact of the 2017 American academy of pediatrics guideline on hypertension prevalence compared with the fourth report in an international cohort. Hypertension 74(6):1343–1348CrossRefPubMed
3.
4.
Zurück zum Zitat Gopinath B, Wang JJ, Kifley A, Tan AG, Wong TY, Mitchell P (2013) Influence of blood pressure and body mass index on retinal vascular caliber in preschool-aged children. J Hum Hypertens 27(9):523–528CrossRefPubMed Gopinath B, Wang JJ, Kifley A, Tan AG, Wong TY, Mitchell P (2013) Influence of blood pressure and body mass index on retinal vascular caliber in preschool-aged children. J Hum Hypertens 27(9):523–528CrossRefPubMed
5.
Zurück zum Zitat Bhargava M, Ikram MK, Wong TY (2012) How does hypertension affect your eyes? J Hum Hypertens 26(2):71–83CrossRefPubMed Bhargava M, Ikram MK, Wong TY (2012) How does hypertension affect your eyes? J Hum Hypertens 26(2):71–83CrossRefPubMed
6.
Zurück zum Zitat Kaushik S, Kifley A, Mitchell P, Wang JJ (2007) Age, blood pressure, and retinal vessel diameter: separate effects and interaction of blood pressure and age. Invest Ophthalmol Vis Sci 48(2):557–561CrossRefPubMed Kaushik S, Kifley A, Mitchell P, Wang JJ (2007) Age, blood pressure, and retinal vessel diameter: separate effects and interaction of blood pressure and age. Invest Ophthalmol Vis Sci 48(2):557–561CrossRefPubMed
7.
Zurück zum Zitat Simsek EE, Kanar HS, Kanar BG, Cetin H, Arsan A, Tigen MK (2020) Can ocular OCT findings be as a predictor for end-organ damage in systemic hypertension? Clin Exp Hypertens 42(8):733–737CrossRefPubMed Simsek EE, Kanar HS, Kanar BG, Cetin H, Arsan A, Tigen MK (2020) Can ocular OCT findings be as a predictor for end-organ damage in systemic hypertension? Clin Exp Hypertens 42(8):733–737CrossRefPubMed
8.
9.
Zurück zum Zitat Akay F, Gundogan FC, Yolcu U, Toyran S, Uzun S (2016) Choroidal thickness in systemic arterial hypertension. Eur J Ophthalmol 26(2):152–157CrossRefPubMed Akay F, Gundogan FC, Yolcu U, Toyran S, Uzun S (2016) Choroidal thickness in systemic arterial hypertension. Eur J Ophthalmol 26(2):152–157CrossRefPubMed
10.
Zurück zum Zitat Aşıkgarip N, Temel E, Kıvrak A, Örnek K (2021) Choroidal structural changes and choroidal vascularity index in patients with systemic hypertension. Eur J Ophthalmol 32:2427CrossRefPubMed Aşıkgarip N, Temel E, Kıvrak A, Örnek K (2021) Choroidal structural changes and choroidal vascularity index in patients with systemic hypertension. Eur J Ophthalmol 32:2427CrossRefPubMed
11.
Zurück zum Zitat Tso MO, Jampol LM (1982) Pathophysiology of hypertensive retinopathy. Ophthalmology 89(10):1132–1145CrossRefPubMed Tso MO, Jampol LM (1982) Pathophysiology of hypertensive retinopathy. Ophthalmology 89(10):1132–1145CrossRefPubMed
12.
Zurück zum Zitat Waghamare SR, Mittal S, Pathania M, Samanta R, Kumawat D, Gupta N et al (2021) Comparison of choroidal thickness in systemic hypertensive subjects with healthy individuals by spectral domain optical coherence tomography. Indian J Ophthalmol 69(5):1183–1188CrossRefPubMedPubMedCentral Waghamare SR, Mittal S, Pathania M, Samanta R, Kumawat D, Gupta N et al (2021) Comparison of choroidal thickness in systemic hypertensive subjects with healthy individuals by spectral domain optical coherence tomography. Indian J Ophthalmol 69(5):1183–1188CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Schuh DS, Piccoli BÂ, Paiani RL, Maciel CR, Pellanda LC, Vilela MA (2017) Ocular signs related to overweight and arterial hypertension in children: a systematic review. Open Ophthalmol J 11:273–285CrossRefPubMedPubMedCentral Schuh DS, Piccoli BÂ, Paiani RL, Maciel CR, Pellanda LC, Vilela MA (2017) Ocular signs related to overweight and arterial hypertension in children: a systematic review. Open Ophthalmol J 11:273–285CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Tapp RJ, Hussain SM, Battista J, Hutri-Kähönen N, Lehtimäki T, Hughes AD et al (2015) Impact of blood pressure on retinal microvasculature architecture across the lifespan: the young finns study. Microcirculation 22(2):146–155CrossRefPubMed Tapp RJ, Hussain SM, Battista J, Hutri-Kähönen N, Lehtimäki T, Hughes AD et al (2015) Impact of blood pressure on retinal microvasculature architecture across the lifespan: the young finns study. Microcirculation 22(2):146–155CrossRefPubMed
15.
Zurück zum Zitat Baker-Smith CM, Flinn SK, Flynn JT, Kaelber DC, Blowey D, Carroll AE et al., (2018) Diagnosis, evaluation, and management of high blood pressure in children and adolescents. Pediatrics 142(3) Baker-Smith CM, Flinn SK, Flynn JT, Kaelber DC, Blowey D, Carroll AE et al., (2018) Diagnosis, evaluation, and management of high blood pressure in children and adolescents. Pediatrics 142(3)
16.
Zurück zum Zitat Dereli Can G, Korkmaz MF, Can ME (2020) Subclinical retinal microvascular alterations assessed by optical coherence tomography angiography in children with systemic hypertension. J AAPOS 24(3):147.e1-147.e6CrossRefPubMed Dereli Can G, Korkmaz MF, Can ME (2020) Subclinical retinal microvascular alterations assessed by optical coherence tomography angiography in children with systemic hypertension. J AAPOS 24(3):147.e1-147.e6CrossRefPubMed
17.
Zurück zum Zitat Mitchell P, Cheung N, de Haseth K, Taylor B, Rochtchina E, Islam FM et al (2007) Blood pressure and retinal arteriolar narrowing in children. Hypertension 49(5):1156–1162CrossRefPubMed Mitchell P, Cheung N, de Haseth K, Taylor B, Rochtchina E, Islam FM et al (2007) Blood pressure and retinal arteriolar narrowing in children. Hypertension 49(5):1156–1162CrossRefPubMed
18.
Zurück zum Zitat Murgan I, Beyer S, Kotliar KE, Weber L, Bechtold-DallaPozza S, DallaPozza R et al (2013) Arterial and retinal vascular changes in hypertensive and prehypertensive adolescents. Am J Hypertens 26(3):400–8CrossRefPubMed Murgan I, Beyer S, Kotliar KE, Weber L, Bechtold-DallaPozza S, DallaPozza R et al (2013) Arterial and retinal vascular changes in hypertensive and prehypertensive adolescents. Am J Hypertens 26(3):400–8CrossRefPubMed
19.
Zurück zum Zitat Vasilevska-Ristovska J, Hudes SZ, Naguleswaran K, Langlois V, Matsuda-Abedini M, Parekh RS (2018) pediatric hypertension: impact on the heart, brain, kidney, and retina. Curr Cardiovasc Risk Rep 12(5):1–10CrossRef Vasilevska-Ristovska J, Hudes SZ, Naguleswaran K, Langlois V, Matsuda-Abedini M, Parekh RS (2018) pediatric hypertension: impact on the heart, brain, kidney, and retina. Curr Cardiovasc Risk Rep 12(5):1–10CrossRef
20.
Zurück zum Zitat Wong TY, Shankar A, Klein R, Klein BE, Hubbard LD (2004) Prospective cohort study of retinal vessel diameters and risk of hypertension. BMJ 329(7457):79CrossRefPubMedPubMedCentral Wong TY, Shankar A, Klein R, Klein BE, Hubbard LD (2004) Prospective cohort study of retinal vessel diameters and risk of hypertension. BMJ 329(7457):79CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Gök M, Karabas VL, Emre E, Aksar AT, Aslan MS, Ural D (2015) Evaluation of choroidal thickness via enhanced depth-imaging optical coherence tomography in patients with systemic hypertension. Indian J Ophthalmol 63(3):239–243CrossRefPubMedPubMedCentral Gök M, Karabas VL, Emre E, Aksar AT, Aslan MS, Ural D (2015) Evaluation of choroidal thickness via enhanced depth-imaging optical coherence tomography in patients with systemic hypertension. Indian J Ophthalmol 63(3):239–243CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Takayama K, Kaneko H, Ito Y, Kataoka K, Iwase T, Yasuma T et al (2018) Novel classification of early-stage systemic hypertensive changes in human retina based on OCTA measurement of choriocapillaris. Sci Rep 8(1):15163CrossRefPubMedPubMedCentral Takayama K, Kaneko H, Ito Y, Kataoka K, Iwase T, Yasuma T et al (2018) Novel classification of early-stage systemic hypertensive changes in human retina based on OCTA measurement of choriocapillaris. Sci Rep 8(1):15163CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Ahn SJ, Woo SJ, Park KH (2014) Retinal and choroidal changes with severe hypertension and their association with visual outcome. Invest Ophthalmol Vis Sci 55(12):7775–7785CrossRefPubMed Ahn SJ, Woo SJ, Park KH (2014) Retinal and choroidal changes with severe hypertension and their association with visual outcome. Invest Ophthalmol Vis Sci 55(12):7775–7785CrossRefPubMed
24.
Zurück zum Zitat Donati S, Maresca AM, Cattaneo J, Grossi A, Mazzola M, Caprani SM et al (2021) Optical coherence tomography angiography and arterial hypertension: a role in identifying subclinical microvascular damage? Eur J Ophthalmol 31(1):158–165CrossRefPubMed Donati S, Maresca AM, Cattaneo J, Grossi A, Mazzola M, Caprani SM et al (2021) Optical coherence tomography angiography and arterial hypertension: a role in identifying subclinical microvascular damage? Eur J Ophthalmol 31(1):158–165CrossRefPubMed
25.
Zurück zum Zitat Izzedine H, Bodaghi B, Launay-Vacher V, Deray G (2003) Eye and kidney: from clinical findings to genetic explanations. J Am Soc Nephrol 14(2):516–529CrossRefPubMed Izzedine H, Bodaghi B, Launay-Vacher V, Deray G (2003) Eye and kidney: from clinical findings to genetic explanations. J Am Soc Nephrol 14(2):516–529CrossRefPubMed
26.
Zurück zum Zitat Farrah TE, Dhillon B, Keane PA, Webb DJ, Dhaun N (2020) The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons. Kidney Int 98(2):323–342CrossRefPubMedPubMedCentral Farrah TE, Dhillon B, Keane PA, Webb DJ, Dhaun N (2020) The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons. Kidney Int 98(2):323–342CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Wong CW, Wong TY, Cheng CY, Sabanayagam C (2014) Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways. Kidney Int 85(6):1290–1302CrossRefPubMed Wong CW, Wong TY, Cheng CY, Sabanayagam C (2014) Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways. Kidney Int 85(6):1290–1302CrossRefPubMed
28.
Zurück zum Zitat Mulè G, Vadalà M, La Blasca T, Gaetani R, Virone G, Guarneri M et al (2019) Association between early-stage chronic kidney disease and reduced choroidal thickness in essential hypertensive patients. Hypertens Res 42(7):990–1000CrossRefPubMed Mulè G, Vadalà M, La Blasca T, Gaetani R, Virone G, Guarneri M et al (2019) Association between early-stage chronic kidney disease and reduced choroidal thickness in essential hypertensive patients. Hypertens Res 42(7):990–1000CrossRefPubMed
29.
Zurück zum Zitat Vadalà M, Castellucci M, Guarrasi G, Terrasi M, La Blasca T, Mulè G (2019) Retinal and choroidal vasculature changes associated with chronic kidney disease. Graefes Arch Clin Exp Ophthalmol 257(8):1687–1698CrossRefPubMed Vadalà M, Castellucci M, Guarrasi G, Terrasi M, La Blasca T, Mulè G (2019) Retinal and choroidal vasculature changes associated with chronic kidney disease. Graefes Arch Clin Exp Ophthalmol 257(8):1687–1698CrossRefPubMed
30.
Zurück zum Zitat Geraci G, Maria Zammuto M, Vadalà M, Mattina A, Castellucci M, Guarrasi G et al (2020) Choroidal thickness is associated with renal hemodynamics in essential hypertension. J Clin Hypertens (Greenwich) 22(2):245–253CrossRefPubMed Geraci G, Maria Zammuto M, Vadalà M, Mattina A, Castellucci M, Guarrasi G et al (2020) Choroidal thickness is associated with renal hemodynamics in essential hypertension. J Clin Hypertens (Greenwich) 22(2):245–253CrossRefPubMed
31.
Zurück zum Zitat Balmforth C, van Bragt JJ, Ruijs T, Cameron JR, Kimmitt R, Moorhouse R et al (2016) Chorioretinal thinning in chronic kidney disease links to inflammation and endothelial dysfunction. JCI Insight 1(20):e89173CrossRefPubMedPubMedCentral Balmforth C, van Bragt JJ, Ruijs T, Cameron JR, Kimmitt R, Moorhouse R et al (2016) Chorioretinal thinning in chronic kidney disease links to inflammation and endothelial dysfunction. JCI Insight 1(20):e89173CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Te Riet L, van Esch JH, Roks AJ, van den Meiracker AH, Danser AH (2015) Hypertension: renin-angiotensin-aldosterone system alterations. Circ Res 116(6):960–975CrossRef Te Riet L, van Esch JH, Roks AJ, van den Meiracker AH, Danser AH (2015) Hypertension: renin-angiotensin-aldosterone system alterations. Circ Res 116(6):960–975CrossRef
Metadaten
Titel
Evaluation of subclinical changes in recently diagnosed pediatric hypertension patients without hypertensive retinopathy: an OCT study
verfasst von
Yusuf Ziya Güven
Fahrettin Akay
Berkay Akmaz
Emine Nursel Akmaz
Çınar Özen
Publikationsdatum
10.01.2023
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 7/2023
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-022-02622-w

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