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Adaptive optics assisted visualization of thickened retinal arterial wall in a patient with controlled malignant hypertension.

Arichika S, Uji A, Yoshimura N - Clin Ophthalmol (2014)

Bottom Line: The average wall thickness, with hypertension, was 18.7 μm, and the wall-to-lumen ratio was 0.44, both bigger than normal.The arterial walls were thickened compared with normal.AO-SLO may facilitate future noninvasive study of arterial walls in human medicine.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

ABSTRACT

Purpose: We aimed to visualize the retinal arterial wall thickness, assisted by noninvasive adaptive optics scanning laser ophthalmoscopy (AO-SLO).

Methods: The arterial wall thickness was measured and compared between one normal subject and one patient suffering from malignant hypertensive retinopathy.

Results: Increased arterial wall thickness was revealed with a newly developed AO-SLO system, in a retinal artery of 1-papilla diameter temporal inferior to the optic disc. The average wall thickness, with hypertension, was 18.7 μm, and the wall-to-lumen ratio was 0.44, both bigger than normal.

Conclusion: AO-SLO enabled us to evaluate the retinal wall thickness in the hypertensive patient. The arterial walls were thickened compared with normal. AO-SLO may facilitate future noninvasive study of arterial walls in human medicine.

No MeSH data available.


Related in: MedlinePlus

Fundus photographs and spectral-domain optical coherence tomography (SD-OCT) before and after treatment.Notes: Images of both eyes of a 33-year-old woman with hypertensive retinopathy (A–D) before treatment and (E–H) 3 months after hypertensive treatment started. (A) Color photograph of the right eye shows retinal hemorrhage, “cotton-wool” spots, papilledema, and macular edema. (B) Horizontal line scan on SD-OCT of the right eye shows serous retinal detachment and hyperreflective foci, representing precursors of hard exudate in the retina. (C) Color photograph of the left eye shows retinal hemorrhage, cotton-wool spots, and papilledema, all of which are milder than those in the right eye. (D) Horizontal line scan on SD-OCT of the left eye shows serous retinal detachment and hyperreflective foci. (E and G) Fundus findings reveal favorable response to hypertensive treatment. (F and H) Horizontal line scans on SD-OCT of both eyes show complete disappearance of serous retinal detachment. The scale bar represents 200 μm. Green arrows represent the sectioned line of the SD-OCT.
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f1-opth-8-2041: Fundus photographs and spectral-domain optical coherence tomography (SD-OCT) before and after treatment.Notes: Images of both eyes of a 33-year-old woman with hypertensive retinopathy (A–D) before treatment and (E–H) 3 months after hypertensive treatment started. (A) Color photograph of the right eye shows retinal hemorrhage, “cotton-wool” spots, papilledema, and macular edema. (B) Horizontal line scan on SD-OCT of the right eye shows serous retinal detachment and hyperreflective foci, representing precursors of hard exudate in the retina. (C) Color photograph of the left eye shows retinal hemorrhage, cotton-wool spots, and papilledema, all of which are milder than those in the right eye. (D) Horizontal line scan on SD-OCT of the left eye shows serous retinal detachment and hyperreflective foci. (E and G) Fundus findings reveal favorable response to hypertensive treatment. (F and H) Horizontal line scans on SD-OCT of both eyes show complete disappearance of serous retinal detachment. The scale bar represents 200 μm. Green arrows represent the sectioned line of the SD-OCT.

Mentions: A 33-year-old woman complaining of decreased vision in the right eye was referred to our institution. Her visual acuity was 20/50 in the right eye and 20/20 in the left eye. Fundus examination revealed retinal hemorrhage, “cotton-wool” spots, and papilledema in both eyes, with macular edema in the right eye (Figure 1). Spectral-domain optical coherence tomography (SD-OCT) (Spectralis®; Heidelberg Engineering, Heidelberg, Germany) showed serous retinal detachment and hyperreflective foci, which represented precursors of hard exudate in the retina. Her blood pressure was 234/134 mmHg, and blood tests showed elevated serum creatinine level (14 mg/dL). Moreover, abdominal magnetic resonance imaging (MRI) revealed bilateral renal atrophy. She was diagnosed with malignant nephrosclerosis, malignant hypertension, and hypertensive retinopathy. Hemodialysis and antihypertensive treatment were started immediately. Three months later, her blood pressure had decreased to 115/69, and abnormal findings, except for minimal deposition of hard exudate in the fundus, had resolved. Visual acuity in the right eye had improved to 20/16. Increased arterial wall thickness was revealed with an AO-SLO system (Canon Inc., Tokyo, Japan) in a retinal artery of 1-papilla diameter temporal inferior to the optic disc in the right eye (Figure 2). The average wall thickness was 18.7 μm, and the wall-to-lumen ratio was 0.44.


Adaptive optics assisted visualization of thickened retinal arterial wall in a patient with controlled malignant hypertension.

Arichika S, Uji A, Yoshimura N - Clin Ophthalmol (2014)

Fundus photographs and spectral-domain optical coherence tomography (SD-OCT) before and after treatment.Notes: Images of both eyes of a 33-year-old woman with hypertensive retinopathy (A–D) before treatment and (E–H) 3 months after hypertensive treatment started. (A) Color photograph of the right eye shows retinal hemorrhage, “cotton-wool” spots, papilledema, and macular edema. (B) Horizontal line scan on SD-OCT of the right eye shows serous retinal detachment and hyperreflective foci, representing precursors of hard exudate in the retina. (C) Color photograph of the left eye shows retinal hemorrhage, cotton-wool spots, and papilledema, all of which are milder than those in the right eye. (D) Horizontal line scan on SD-OCT of the left eye shows serous retinal detachment and hyperreflective foci. (E and G) Fundus findings reveal favorable response to hypertensive treatment. (F and H) Horizontal line scans on SD-OCT of both eyes show complete disappearance of serous retinal detachment. The scale bar represents 200 μm. Green arrows represent the sectioned line of the SD-OCT.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4199820&req=5

f1-opth-8-2041: Fundus photographs and spectral-domain optical coherence tomography (SD-OCT) before and after treatment.Notes: Images of both eyes of a 33-year-old woman with hypertensive retinopathy (A–D) before treatment and (E–H) 3 months after hypertensive treatment started. (A) Color photograph of the right eye shows retinal hemorrhage, “cotton-wool” spots, papilledema, and macular edema. (B) Horizontal line scan on SD-OCT of the right eye shows serous retinal detachment and hyperreflective foci, representing precursors of hard exudate in the retina. (C) Color photograph of the left eye shows retinal hemorrhage, cotton-wool spots, and papilledema, all of which are milder than those in the right eye. (D) Horizontal line scan on SD-OCT of the left eye shows serous retinal detachment and hyperreflective foci. (E and G) Fundus findings reveal favorable response to hypertensive treatment. (F and H) Horizontal line scans on SD-OCT of both eyes show complete disappearance of serous retinal detachment. The scale bar represents 200 μm. Green arrows represent the sectioned line of the SD-OCT.
Mentions: A 33-year-old woman complaining of decreased vision in the right eye was referred to our institution. Her visual acuity was 20/50 in the right eye and 20/20 in the left eye. Fundus examination revealed retinal hemorrhage, “cotton-wool” spots, and papilledema in both eyes, with macular edema in the right eye (Figure 1). Spectral-domain optical coherence tomography (SD-OCT) (Spectralis®; Heidelberg Engineering, Heidelberg, Germany) showed serous retinal detachment and hyperreflective foci, which represented precursors of hard exudate in the retina. Her blood pressure was 234/134 mmHg, and blood tests showed elevated serum creatinine level (14 mg/dL). Moreover, abdominal magnetic resonance imaging (MRI) revealed bilateral renal atrophy. She was diagnosed with malignant nephrosclerosis, malignant hypertension, and hypertensive retinopathy. Hemodialysis and antihypertensive treatment were started immediately. Three months later, her blood pressure had decreased to 115/69, and abnormal findings, except for minimal deposition of hard exudate in the fundus, had resolved. Visual acuity in the right eye had improved to 20/16. Increased arterial wall thickness was revealed with an AO-SLO system (Canon Inc., Tokyo, Japan) in a retinal artery of 1-papilla diameter temporal inferior to the optic disc in the right eye (Figure 2). The average wall thickness was 18.7 μm, and the wall-to-lumen ratio was 0.44.

Bottom Line: The average wall thickness, with hypertension, was 18.7 μm, and the wall-to-lumen ratio was 0.44, both bigger than normal.The arterial walls were thickened compared with normal.AO-SLO may facilitate future noninvasive study of arterial walls in human medicine.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

ABSTRACT

Purpose: We aimed to visualize the retinal arterial wall thickness, assisted by noninvasive adaptive optics scanning laser ophthalmoscopy (AO-SLO).

Methods: The arterial wall thickness was measured and compared between one normal subject and one patient suffering from malignant hypertensive retinopathy.

Results: Increased arterial wall thickness was revealed with a newly developed AO-SLO system, in a retinal artery of 1-papilla diameter temporal inferior to the optic disc. The average wall thickness, with hypertension, was 18.7 μm, and the wall-to-lumen ratio was 0.44, both bigger than normal.

Conclusion: AO-SLO enabled us to evaluate the retinal wall thickness in the hypertensive patient. The arterial walls were thickened compared with normal. AO-SLO may facilitate future noninvasive study of arterial walls in human medicine.

No MeSH data available.


Related in: MedlinePlus