Analysis of Angiographic Features in Hypertensive Patients Using OCT Angiography

Abstract Purpose: To evaluate retinal microvascular alterations in hypertensive patients using optical coherence tomography angiography (OCTA) and assess its role as a biomarker of target organ damage. Methods: This cross-sectional comparative study included 226 eyes of 113 individuals aged >18 years. OCTA parameters, such as foveal avascular zone (FAZ) area and parafoveal vessel density, were measured. Visual acuity, blood pressure, and duration of hypertension were recorded. Independent t -test and Pearson correlation were applied for analyses. Results: FAZ enlargement was observed in both superficial (0.43 ± 0.15 mm²) and deep (0.39 ± 0.16 mm²) plexuses. Deep FAZ area showed a significant negative correlation with systolic blood pressure ( r = −0.218, P = 0.020). Parafoveal vessel density was significantly reduced across all quadrants (temporal 45.54% ± 3.48%, nasal 42.30% ± 4.14%, inferior 47.24% ± 3.92%, superior 47.21% ± 4.24%), with weak but significant negative correlations with disease duration. Vessel density did not differ by retinopathy status. Conclusion: OCTA identifies early retinal microvascular changes in hypertensive patients, correlating with blood pressure and duration of disease. These findings support its role as a non-invasive biomarker for hypertensive vascular damage. Larger, controlled longitudinal studies are needed to confirm its predictive and clinical value.