J Korean Ophthalmol Soc.  2014 Jun;55(6):840-846.

Changes in Subfoveal Choroidal Thickness in Malignant Hypertension Patients

• Kim JW
• Kim YT

Abstract

PURPOSE
To evaluate changes in subfoveal choroidal thickness in patients with malignant hypertension.
METHODS
A total of 12 eyes of six malignant hypertension patients were included in the present study. Intraocular pressure, blood pressure (systolic and diastolic), and choroidal thickness were measured before and after blood pressure control. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). The changes in choroidal extravascular density of the EDI-OCT image after blood pressure control were evaluated by comparing brightness values obtained with Adobe Photoshop software.
RESULTS
The subfoveal choroidal thickness (SFCT) of malignant hypertension patients was 412.63 +/- 66.55 microm (mean +/- SD), which was thicker than in normal patients. After blood pressure control, SFCT decreased significantly to 356.96 +/- 59.08 microm (mean +/- SD) (p = 0.002). The choroidal extravascular density of the EDI-OCT image decreased after blood pressure control (p = 0.002), and the mean change was 17.21 +/- 7.56.
CONCLUSIONS
The choroid is thickened in patients with malignant hypertension, and its thickness decreases after blood pressure control. This suggests that changes in blood pressure may affect choroidal thickness.

Keyword

Choroidal thickness; Hypertensive retinopathy; Malignant hypertension; OCT

MeSH Terms

Blood Pressure
Choroid*
Humans
Hypertension, Malignant*
Hypertensive Retinopathy
Intraocular Pressure
Tomography, Optical Coherence

Figure

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  Figure 1. Patient No 5. The right eye of the 20-year-old woman who had been diagnosed with nephrotic hypertension 2 months before. Fundus examination showed multiple cotton wool spots and hard exudates with papilledema. (C) The retinal detachment and macular edema were not seen in enhanced depth imaging optical coherence tomography (EDI-OCT). (A) However, subfoveal cho-roidal thickness (SFCT) was 442.5 μm, which is thickened. (A, white line) After blood pressure control, follow-up examinationshows spontaneous resolution of the cotton wool sopts and papilledema (D), SFCT decreased to 297.0 μm (B, white line).

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  Figure 2. The choroidal extravascular density of the enhanced depth imaging optical coherence tomography (EDI-OCT) image was evaluated by Photoshop-based image analysing software. In the histogram, each vertical line represents the number of pixels with brightness. The mean value reveals the staining intensity of the selected area, the choroidal layer.

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  Figure 3. Patient No. 6. The eyes of 29-year-old man with essential hypertension a month before. On examination, blood pressure was 220/150 mm Hg and fundus biomicroscopy revealed multiple cotton wool spots, hard exudates and papilledema (C, D). In the right eye on enhanced depth imaging optical coherence tomography (EDI-OCT), macular edema and serous retinal detachment is seen. (A) The subfoveal choroidal thickness (SFCT) increased in both eyes, which was 422.0 μm in the right eye (A, white line) and 446.5 μm in the left eye (B, white line).

Reference

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