Sheludchenko VM, Kozlovskaya NL, Budzinskaya MV, Krasnolutskaya EI, Durzhinskaya MH, Smirnova TV, Bondarenko TV. [The role of optical coherence tomography angiography in the assessment of retinal microcirculation in thrombotic microangiopathy associated with malignant arterial hypertension].
Vestn Oftalmol 2022;
138:177-185. [PMID:
36287153 DOI:
10.17116/oftalma2022138052177]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
UNLABELLED
Optical coherence tomography angiography (OCT-A) allows detailed assessment of the state of local blood flow in various systemic ischemic diseases, which include thrombotic microangiopathy (TMA) associated with malignant arterial hypertension (MAH).
PURPOSE
To evaluate retinal microcirculation using OCT-A imaging data in the group of patients with TMA associated with MAH.
MATERIAL AND METHODS
The study consisted of a qualitative and quantitative analysis of OCT-A data from 7 patients (14 eyes) with TMA associated with MAH and verified by renal biopsy. The control group included 7 healthy individuals (14 eyes). The following parameters were analyzed: area size of the foveal avascular zone FAZ, mm, vessel density (VD, %) and vessel skeleton density (VSD, %). The indicators were measured separately in the deep and superficial vascular plexuses and divided by localization into: the total density of the entire measured area, central density, density by quadrants (superior, inferior, nasal and temporal). All quadrants were subdivided into inner (corresponding to parafovea) and outer (corresponding to perifovea).
RESULTS
Local foci of vascular attenuation of the deep retinal capillary plexus, pathological tortuosity of blood vessels in the deep and superficial retinal capillary plexuses were found in 100% of study group patients. Per-quadrant analysis of OCT-A finding in the macular zone revealed a statistically significant decrease in VD of the deep retinal capillary plexus (p<0.05). A direct correlation was found between glomerular filtration rate and the VD index in the outer inferior (r=0.567; p=0.034) and inner temporal quadrants (r=0.613; p=0.020) of the deep retinal capillary plexus, as well as the level of hemoglobin in blood serum and VD in inner temporal quadrant of the deep vascular plexus (r=0.596; p=0.025).
CONCLUSION
Changes revealed with OCT-A are the symptoms of TMA in MAH patients spreading to the retinal microvasculature, mainly at the level of the deep retinal capillary plexus.
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