Association Between Systemic Hypertension and Macular Thickness Measured by Optical Coherence Tomography.
OBJECTIVE
This study aimed to evaluate an association between hypertension and macular thickness.


METHODS
A total of 827 Korean adults composed of 163 pairs of twins and their family members were included in this population-based cross-sectional study. Macular thickness was measured with optical coherence tomography at nine macular subfields defined by the Early Treatment of Diabetic Retinopathy Study. Cardiometabolic risk factors, including body mass index (BMI), hypertension, diabetes, lipid profiles, and smoking status, were assessed. Linear mixed regression analysis was conducted with consideration of familial correlations and adjustment for covariates.


RESULTS
Age-, sex-, and axial length-adjusted analysis showed that systemic hypertension was associated with a significant change in macular thickness in most subfields except for the fovea. Compared with normotensive subjects, macular thickness was lower in subjects with systemic hypertension (P ≤ 0.05), with the highest difference (2.52%) in the outer temporal region and the lowest difference (1.44%) in the inner temporal region. This association persisted even after adjusting for other cardiometabolic risk factors. Other cardiometabolic risk factors were not independently associated with macular thickness in any subfields. Stratified analysis showed that the inverse association between macular thickness and hypertension was stronger in the group with elevated fasting glucose compared with the group with normal fasting glucose (P for interaction ≤ 0.05).


CONCLUSIONS
Systemic hypertension was inversely associated with macular thickness in most macular subfields, particularly in subjects with an elevated fasting glucose level. This finding suggests that it may be necessary to consider the presence of hypertension when macular thickness and pericentral macular area volume are evaluated.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Mingui
M
Kong
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Youngkyo
Y
Kwun
Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea 3Institute of Health Environment, Seoul National University, Seoul, Korea.
Joohon
J
Sung
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Don-Il
DI
Ham
Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yun-Mi
YM
Song
D000328:Adult; D003430:Cross-Sectional Studies; D004200:Diseases in Twins; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis; D015994:Incidence; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012164:Retinal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence