Longitudinal changes in the thickness of the ganglion cell–inner plexiform layer in patients with hypertension: a 4-year prospective observational study

Abstract

Purpose: Hypertension (HTN) is expected to accelerate age-related ganglion cell–inner plexiform layer thickness (GC-IPLs) reduction, but there is limited information on the reduction rate of GC-IPLs in HTN patients. We investigate longitudinal changes in the thickness of GC-IPL in patients with HTN. Methods: We performed a prospective, longitudinal and observational study design. Participants were divided into two groups: HTN group (49 eyes) and control group (56 eyes). After the initial visit, GC-IPLs were measured four times at 1-year intervals using spectral-domain optical coherence tomography. The GC-IPL reduction rate was estimated using a linear mixed model and compared between the two groups. Univariate and multivariate generalized linear mixed models were used to identify factors associated with reductions in GC-IPLs over time. Results: In a linear mixed model, the GC-IPL reduction rates for the HTN and control groups were −0.64 (p < 0.001) and −0.19 (p < 0.001) μm/year, respectively, and the interaction between group and follow-up duration was significant (p < 0.001). In the HTN group, all sectors exhibited significant reductions over time (all p < 0.001). Results from univariate and multivariate linear mixed model analyses revealed that age and IOP were significantly associated (p = 0.009 and 0.047, respectively) with reductions in GC-IPLs in HTN patients. Conclusion: Patients with HTN exhibited a significant reduction in GC-IPLs compared to normal subjects. Additionally, age and IOP affected the reduction rate of GC-IPLs in HTN patients. In various ophthalmic diseases, physicians should consider the longitudinal effect of HTN on GC-IPLs.