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Hypertension, Deep Retinal Perfusion, and Concurrent Visual Acuity in Retinal Vein Occlusion: A Cross-Sectional OCTA Study

Year: 2026

Type: article

Abstract: Background: To investigate the cross-sectional association between hypertension and OCTA-derived retinal microvascular characteristics and to assess whether deep capillary plexus perfusion area (DCP-PA) provides additional explanatory information for concurrent visual acuity in retinal vein occlusion (RVO). Methods: This retrospective secondary cross-sectional analysis included 88 RVO-affected eyes from 88 patients. Best-corrected visual acuity (BCVA) and swept-source OCTA were assessed at the same visit. Multivariable linear regression evaluated associations between hypertension and six OCTA outcomes after adjustment for age, sex, RVO subtype, and hyperlipidemia, with Benjamini–Hochberg false-discovery-rate (FDR) correction. The association between DCP-PA and concurrent logMAR BCVA was assessed using a clinical-structural model including age, sex, RVO subtype, hypertension, hyperlipidemia, and total retinal thickness (TRT), followed by an extended model incorporating DCP-PA. Results: Hypertension was associated with lower DCP-PA (β=− 1.71; 95% CI, − 2.85 to − 0.57; FDR-adjusted P=0.011) and lower DCP vessel length density (β=− 3.29; 95% CI, − 5.48 to − 1.09; FDR-adjusted P=0.011). Lower DCP-PA remained independently associated with worse concurrent visual acuity after adjustment for clinical factors and TRT (β=− 0.12 per mm 2 ; 95% CI, − 0.16 to − 0.08; P< 0.001). Hyperlipidemia was also associated with worse visual acuity (β=0.34; 95% CI, 0.18 to 0.49; P< 0.001). Adding DCP-PA increased adjusted R 2 from 0.40 to 0.59 and reduced AIC from 94.60 to 61.99 (partial F=38.54; P< 0.001). No significant interaction was observed between DCP-PA and RVO subtype (P=0.353). Conclusions: Hypertension was associated with reduced deep retinal perfusion in RVO. Lower DCP-PA was independently associated with worse concurrent visual acuity and provided additional explanatory information beyond clinical factors and retinal thickness. These cross-sectional findings do not establish causality or prospective prognostic value. Keywords: retinal vein occlusion, OCT angiography, deep capillary plexus, hypertension, visual acuity

Source: Clinical ophthalmology

DOI: 10.2147/opth.s652471

Authors: Jinlian Zhan, Yanting Lai, Haichun Li, Lin Lu, Xiujuan Zhao

Institution: Zhongshan Ophthalmic Center, Sun Yat-sen University

Language: English

Topic: Retinal Diseases and Treatments

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,320