İhsan AKDAĞ, Merve ORAL, Mustafa CANDEMİR, Betül Ayça YAMAK, Hüseyin Baran ÖZDEMİR
Retina-Vitreus - 2026;35(3):264-268
Purpose: To investigate the effect of nocturnal blood pressure (BP) patterns on macular microvasculature in patients with newly diagnosed essential hypertension using optical coherence tomography angiography (OCTA). Methods: This cross-sectional, observational study included 26 patients with newly diagnosed essential hypertension. Based on 24-hour ambulatory blood pressure monitoring (ABPM), patients were classified as "dippers" (>=10% nocturnal systolic BP reduction) or "non-dippers" (<10% reduction). All participants underwent macular OCTA (6x6 mm scan) and echocardiographic assessment. OCTA parameters included foveal avascular zone (FAZ) area, foveal density, and vessel densities in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Demographic, BP, and OCTA data were compared between groups. Results: The study included 52 eyes from 26 patients (mean age: 53.8 +/- 7.8 years; 17 females). Of these, 10 were dippers and 16 were non-dippers. SCP whole image, inferior, and perifoveal, as well as DCP parafoveal and perifoveal vessel densities, were significantly higher in non-dippers (p-values <0.05). No significant differences were found in FAZ area or foveal density. Conclusion: Non-dipper patients exhibited increased retinal capillary density in selected macular regions, suggesting early vascular remodeling or venular dilation in response to altered nocturnal BP regulation. OCTA may serve as a non-invasive tool to detect early retinal microvascular changes associated with hypertension.
