RETINAL CAPILLARY DENSITY IN PATIENTS WITH ARTERIAL-HYPERTENSION - 2-YEAR FOLLOW-UP

Background: Arterial hypertension is known to be an important risk fac tor for cerebral and cardiovascular disease. Previous studies have dem onstrated a decrease of capillary density in the perifoveal network in tandem with decreased capillary flow velocity in patients with essent ial hypertension. In a prospective study we quantified the retinal mic rocirculation in order to evaluate the time course of changes in the p erifoveal network. Methods: Thirty-three patients with essential hyper tension (mean age 45+/-14 years) underwent video-fluorescein angiograp hic studies at baseline and at 2 years (28+/-6 months) thereafter. The angiograms were obtained with a scanning laser ophthalmoscope and wer e digitally recorded. By means of digital image analysis we quantified off-line the mean area of perifoveal intercapillary areas (PIA) and t he mean capillary flow velocity. Results: At baseline, the patients wi th hypertension showed significantly increased PIA and a significantly decreased capillary flow velocity compared with reference values. Dur ing the follow-up period the capillary flow velocity decreased further significantly, whereas the PIA showed no significant change. Conclusi ons: The continuous decrease of capillary flow velocity demonstrates a progression of altered microcirculation in patients with essential hy pertension whose blood pressure was believed to be well controlled. Fu rther studies with this technique may be useful to determine the influ ence of antihypertensive therapy and may help to identify patients at risk for cerebrovascular events.