Retinal vascular density in children with hypertension

TL;DR

This study found that children with new-onset hypertension show early signs of kidney and retinal vascular changes, suggesting the need for early monitoring.

Contribution

The study introduces OCT-A as a potential tool for detecting early microvascular changes in pediatric hypertension.

Findings

Children with hypertension had higher cystatin C levels and lower GFR compared to controls.

Retinal vascular density was significantly lower in the hypertension group as measured by OCT-A.

OCT-A may help detect early microvascular changes in newly diagnosed pediatric hypertension.

Abstract

Early detection of ophthalmological and kidney complications of hypertension in children and adolescents may play a significant role in prophylaxis and prevent irreversible organ damage. This study aimed to assess standard kidney injury markers (creatinine, urea, uric acid, cystatin C, 24-h microalbuminuria), as well as potential ophthalmological changes using optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) in the early course of newly diagnosed hypertension in children and adolescents.

The study group consisted of 56 children and adolescents with newly diagnosed hypertension who had not received antihypertensive treatment prior to the study. Fifteen individuals served as controls. The ECHO, abdominal ultrasound, ophthalmological examination, urine and blood tests were performed.

The concentration of cystatin C was increased in patients with hypertension. Children and adolescents with hypertension had decreased values of GFR (90.31 ± 13.00 ml/min/1.73 m2), estimated by the Filler equation, compared to subjects with optimal values of blood pressure (99.00 ± 9.27 ml/min/1.73 m2). The data revealed statistically significant differences in the retinal vessel density analyzed by OCT-A, which was decreased in the control group compared with the study group.

Pediatric patients with newly diagnosed hypertension have increased concentrations of cystatin C and hypofiltration estimated by the Filler equation. OCT-A might be considered a diagnostic tool for better understanding the early process of microvascular changes and the influence of concomitant comorbidities in newly diagnosed systemic hypertension.

A higher-resolution version of the Graphical abstract is available as Supplementary information

A higher-resolution version of the Graphical abstract is available as Supplementary information

The online version contains supplementary material available at 10.1007/s00467-025-07076-7.

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