To Compare Rnfl Thickness in Hypertensive Patients on Antihypertensive Treatment and Normotensive by using Optical Coherence Tomography

Introduction: Hypertension is the health related risk factor in India with an increasing proportion of elderly people, a sedentary lifestyle and obesity associated with increasing urbanization and other lifestyle factors like high levels of salt intake, alcohol and tobacco consumption are contributing to this burden of hypertension. Hypotension following antihypertensive treatment is associated with retinal nerve fibre loss. Altered autoregulation of retinal circulation in hypertension and hypotension leading to hypoprfusion and ischemia of the tissues of retinal nerve fibres. Aim and Objectives: (1). To Compare RNFL thickness in hypertensive Patients on antihypertensive treatment and normotensive (Control Groups) by using Optical Coherence Tomography. (2). To comparison of RNFL thickness in hypertensive patients on different anti-hypertensive agent by using cirrus HD-OCT 500. (3). To comparison of RNFL thickness in different long duration of hypertension in patients by using cirrus HD-OCT 500. Materials and Methods: In a tertiary care facility, this cross-sectional study was carried out. The study included age-matched normotensives and patients with a diagnosis of hypertension. Therefore, a total of 100 patients, 50 patients with systemic hypertension and 50 age matched normotensives (above 40 years) were studied. Blood pressure measured using sphygmomanometer. Systolic BP, diastolic BP and pulse pressure measurement. Difference between (systolic, diastolic, mean arterial) blood pressure and IOP defined as ocular systolic perfusion pressure, ocular diastolic perfusion pressure and mean ocular perfusion pressure. Photography of the RNFL finding will be captured using OCT. Results: In our study statistically significant average RNFL thickness was detected in hypertensives on antihypertension treatment 98.31±7.01, when compared to the normotensives 102.51±8.72. Significant RNFL thickness reduction in hypertensives using antihypertensive medication suggests altered autoregulation, and low mean, diastolic, and systolic ocular perfusion pressure have raised the risk of optic nerve head damage. Furthermore, a number of studies have demonstrated that antihypertensive medications will lower the ocular perfusion pressure, which could potentially harm the perfusion of the optic nerve head. In the hypertensives group, the average RNFL thickness showed the reduction was significant over time (P < 0.001). Conclusion: In conclusion, the RNFL thickness in hypertensives patients on antihypertension treatment statistically significant reduced than average RNFL thickness in normotensives patients. The RNFL thickness of all four quadrant showed a significant reduction over time.