Abstract:

 Objective To investigate the relationship between ocular fundus lesion grading and ocular hemodynamics parameters in hypertensive patients. Design Case-control study. Participants A total of 120 medical hospitalized hypertensive patients in Wangjing Hospital. Methods The fundus color photographys of the both eyes of the 120 patients were collected using the TOPCON fundus camera in the pupil fully dispersed. The hypertensive retinopathy was graded according to the Keith-Wagener method. The retinal arteriosclerosis grade was performed according to the Scheie method. Hemodynamic parameters of ophthalmic artery (OA) and central retinal artery(CRA) were measured by color Doppler ultrasound. The differences of hemodynamics parameters, including peak systolic velocity (PSV), end-diastolic velocity(EDV), medial flow velocity (MFV), pulsatility index(PI), drag index (RI) of the OA and the CRA were compared between different grades. S/D=PSV/EDV. Main Outcome Measures The hemodynamic parameters, including PSV, EDV, MFV, PI, RI, S/D of the OA and the CRA. Results The EDV, PI, RI and S/D of the OA of the patients with hypertensive retinopathy level Ⅱ, level Ⅲ and above were (10.14±2.13) cm/s and (8.06±0.26) cm/s (t=-8.64，P=0.001), 1.28±0.21 and 1.56±0.24 (t=24.6，P=0.001), 0.69±0.12 and 0.75±0.12 (t=68.4，P=0.001), 3.22±0.87 and 4.18±1.14 (t=18.9，P=0.001). The EDV, PI, RI and S/D of the CRA of the patients with hypertensive retinopathy level Ⅱ, level Ⅲ and above were (3.73±0.39) cm/s and (3.18±0.44) cm/s (t=-23.41, P=0.000), 1.07±0.08 and 1.28±0.10 (t=18.7, P=0.001), 0.62±0.02 and 0.68±0.04 (t=17.32, P=0.000), 2.66±0.41 and 2.99±0.27 (t=35.6, P=0.002). The EDV, PI, RI and S/D of the OA of the patients with retinal arteriosclerosis level Ⅱ, level Ⅲ and level Ⅳ were (10.30±2.27) cm/s, (8.90±0.93)cm/s, (7.74±0.74) cm/s (F=7.509，P=0.003)；1.23±0.22, 1.40±0.24, 1.58±0.38 (F=36.214，P=0.003)；0.68±0.01, 0.72±0.02, 0.77±0.01 (F=121.615，P=0.000)；3.08±0.67, 3.61±1.01, 4.32±1.65(F=28.514，P=0.003). The EDV, PI, RI and S/D of the CRA of the patients with retinal arteriosclerosis level Ⅱ,  level Ⅲ and level Ⅳ were (3.78±0.33) cm/s, (3.47±0.28) cm/s, (2.91±0.27) cm/s(F=-22.377, P=0.000)；1.04±0.06, 1.16±0.13, 1.38±0.12(F=17.619，P=0.003)；0.61±0.02, 0.65±0.06, 0.72±0.02(F=24.156，P=0.000); 2.58±0.31, 2.89±0.40, 3.55±0.41 (F=15.424，P=0.000). Conclusion There was a correlation between ocular fundus lesion grading and ocular hemodynamics in hypertensive patients. With the increasing of retinopathy grading, the velocity of end-diastolic blood flow in the ophthalmic artery and central retinal artery decreased, the pulsatility index increased and the resistance index increased.

Key words: hypertensive retinopathy, retinal arteriosclerosis, hemodynamic parameters