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

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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.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. 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):1154–1163

    Article  PubMed  PubMed Central  Google Scholar 

  2. 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):1343–1348

    Article  CAS  PubMed  Google Scholar 

  3. Brady TM, Feld LG (2009) Pediatric approach to hypertension. Semin Nephrol 29(4):379–388

    Article  PubMed  Google Scholar 

  4. 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):523–528

    Article  CAS  PubMed  Google Scholar 

  5. Bhargava M, Ikram MK, Wong TY (2012) How does hypertension affect your eyes? J Hum Hypertens 26(2):71–83

    Article  CAS  PubMed  Google Scholar 

  6. 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):557–561

    Article  PubMed  Google Scholar 

  7. 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):733–737

    Article  PubMed  Google Scholar 

  8. Nickla DL, Wallman J (2010) The multifunctional choroid. Prog Retin Eye Res 29(2):144–168

    Article  PubMed  Google Scholar 

  9. Akay F, Gundogan FC, Yolcu U, Toyran S, Uzun S (2016) Choroidal thickness in systemic arterial hypertension. Eur J Ophthalmol 26(2):152–157

    Article  PubMed  Google Scholar 

  10. Aşıkgarip N, Temel E, Kıvrak A, Örnek K (2021) Choroidal structural changes and choroidal vascularity index in patients with systemic hypertension. Eur J Ophthalmol 32:2427

    Article  PubMed  Google Scholar 

  11. Tso MO, Jampol LM (1982) Pathophysiology of hypertensive retinopathy. Ophthalmology 89(10):1132–1145

    Article  CAS  PubMed  Google Scholar 

  12. 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):1183–1188

    Article  PubMed  PubMed Central  Google Scholar 

  13. 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 11:273–285

    Article  PubMed  PubMed Central  Google Scholar 

  14. 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):146–155

    Article  PubMed  Google Scholar 

  15. 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. 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.e6

    Article  PubMed  Google Scholar 

  17. 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):1156–1162

    Article  CAS  PubMed  Google Scholar 

  18. 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):400–8

    Article  CAS  PubMed  Google Scholar 

  19. 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):1–10

    Article  Google Scholar 

  20. 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):79

    Article  PubMed  PubMed Central  Google Scholar 

  21. 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):239–243

    Article  PubMed  PubMed Central  Google Scholar 

  22. 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):15163

    Article  PubMed  PubMed Central  Google Scholar 

  23. 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):7775–7785

    Article  PubMed  Google Scholar 

  24. 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):158–165

    Article  PubMed  Google Scholar 

  25. 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):516–529

    Article  PubMed  Google Scholar 

  26. 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):323–342

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wong CW, Wong TY, Cheng CY, Sabanayagam C (2014) Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways. Kidney Int 85(6):1290–1302

    Article  PubMed  Google Scholar 

  28. 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):990–1000

    Article  PubMed  Google Scholar 

  29. 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):1687–1698

    Article  PubMed  Google Scholar 

  30. 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):245–253

    Article  CAS  PubMed  Google Scholar 

  31. 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):e89173

    Article  PubMed  PubMed Central  Google Scholar 

  32. 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):960–975

    Article  Google Scholar 

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Acknowledgements

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Authors and Affiliations

  1. Department of Ophthalmology, İzmir Katip Çelebi University Atatürk Educating and Research Hospital, 35200, İzmir, Turkey

    Yusuf Ziya Güven

  2. Department of Ophthalmology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey

    Fahrettin Akay

  3. Department of Ophthalmology, Manisa State Hospital, Manisa, Turkey

    Berkay Akmaz

  4. Department of Pediatrics, Manisa State Hospital, Manisa, Turkey

    Emine Nursel Akmaz

  5. Department of Pediatric Nephrology, Manisa State Hospital, Manisa, Turkey

    Çınar Özen

Authors
  1. Yusuf Ziya Güven
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  2. Fahrettin Akay
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  4. Emine Nursel Akmaz
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  5. Çınar Özen
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Contributions

YZG: wrote the main manuscript, YZG and FA: designed the study. FA: analyzed the data. BA: collected and analyzed the data. ENA: collected the data. ÇÖ: collected the data. All authors reviewed the manuscript.

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Correspondence to Yusuf Ziya Güven.

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Güven, Y.Z., Akay, F., Akmaz, B. et al. Evaluation of subclinical changes in recently diagnosed pediatric hypertension patients without hypertensive retinopathy: an OCT study. Int Ophthalmol 43, 2265–2272 (2023). https://doi.org/10.1007/s10792-022-02622-w

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  • DOI: https://doi.org/10.1007/s10792-022-02622-w

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