title: The Correlation of Retinal Nerve Fiber Layer Thickness With Blood Pressure in a Chinese Hypertensive Population.
abstract: To investigate the association between retinal nerve fiber layer (RNFL) thickness and blood pressure (BP) in subjects with systemic hypertension. Subjects with systemic hypertension on anti-hypertensive medications were screened by fundus photography and referred for glaucoma work-up if there was enlarged vertical cup-to-disc (VCDR) ratio ≥0.6, VCDR asymmetry ≥0.2, or optic disc hemorrhage. Workup included a complete ophthalmological examination, Humphrey visual field test, and RNFL thickness measurement by optical coherence tomography. The intraocular pressure (IOP) and RNFL thicknesses (global and quadrant) were averaged from both eyes and the means were correlated with: the systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) using Pearson correlation. Among 4000 screened hypertensive subjects, 133 were referred for glaucoma workup and 110 completed the workup. Of the 4000 screened subjects, 1.3% had glaucoma (0.9% had normal tension glaucoma [NTG], 0.2% had primary open angle glaucoma, and 0.2% had primary angle closure glaucoma), whereas 0.3% were NTG suspects. The SBP was negatively correlated with the mean superior RNFL thickness (P = 0.01). The DBP was negatively correlated with the mean global (P = 0.03), superior (P = 0.02), and nasal (P = 0.003) RNFL thickness. The MAP was negatively correlated with the mean global (P = 0.01), superior (P = 0.002), and nasal (P = 0.004) RNFL thickness while positively correlated with the mean IOP (P = 0.02). In medically treated hypertensive subjects, glaucoma was present in 1.3%, with NTG being most prevalent. MAP control may help with IOP lowering and RNFL preservation, although future prospective studies will be needed.
authors.affiliation: From the Department of Ophthalmology, The University of Hong Kong (RAG, JWYL, JSML), Department of Ophthalmology, Queen Mary Hospital (RAG, JCHC, JSML), Department of Ophthalmology, Caritas Medical Centre (JWYL), Department of Family Medicine and Primary Health Care, Hospital Authority (HYM, ASKK, JHLW, WWST), and School of Optometry, The Hong Kong Polytechnic University, Hong Kong (RS).
authors.forename: Rita A
authors.initials: RA
authors.lastname: Gangwani
authors.forename: Jacky W Y
authors.initials: JWY
authors.lastname: Lee
authors.forename: H Y
authors.initials: HY
authors.lastname: Mo
authors.forename: Rita
authors.initials: R
authors.lastname: Sum
authors.forename: Alfred S K
authors.initials: ASK
authors.lastname: Kwong
authors.forename: Jenny H L
authors.initials: JHL
authors.lastname: Wang
authors.forename: Wendy W S
authors.initials: WWS
authors.lastname: Tsui
authors.forename: Jonathan C H
authors.initials: JCH
authors.lastname: Chan
authors.forename: Jimmy S M
authors.initials: JSM
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001794:Blood Pressure; D005260:Female; D005901:Glaucoma / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*