Changes in thickness of central macula and retinal nerve fibre layer in severe hypertensive retinopathy: a 1-year longitudinal study.

OBJECTIVE: To analyse the longitudinal changes in the thickness of the central macula and retinal nerve fibre layer (RNFL) in patients with hypertensive retinopathy (HTNR) using spectral-domain optical coherence tomography (SD-OCT).

METHODS: This was a prospective cohort study. We studied 18 eyes of patients with HTNR of grade IV who had been followed up for more than 1 year, and 36 normal eyes (without any relevant medical history; the control group). Antihypertensive treatment successfully normalized the blood pressure of HTNR patients. The RNFL thickness and that of the central macula of HTNR patients were measured using a Cirrus HD-OCT instrument, and compared with those of the control group.

RESULTS: At 12 months of follow-up, the mean thickness of the RNFL and central macula was significantly lower in the HTNR group than in the control group (the RNFL was measured first, and then the central macular thickness (CMT): 77.4 ± 9.1 and 233.8 ± 30.8 μm versus 94.1 ± 7.8 and 256.3 ± 28.1 μm, respectively; p < 0.05). With time, the RNFL thickness and CMT became significantly less than that at the initial diagnosis (p < 0.05).

CONCLUSION: Severe HTNR causes a decrease in the thickness of the RNFL and central macula over time. Therefore, the impact of retinal changes associated with systemic diseases such as hypertension should be considered in analysing the thicknesses of the RNFL and central macula in ocular disorders, including retina, glaucoma and neuro-ophthalmologic diseases.