{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T20:04:13Z","timestamp":1776542653059,"version":"3.51.2"},"reference-count":35,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>To compare retinal microvascular perfusion between the eyes of hypertensive patients with and without chronic kidney disease (CKD), the vessel density (VD) and fractal dimension (FD) of the superficial (SVP) and deep retinal vascular plexus (DVP) were analyzed on 6 \u00d7 6 mm fovea-centered optical coherence tomography angiography (OCTA) images of patients with hypertension. The retina was divided into an inner ring (IR) and outer ring (OR) according to the Early Treatment of Diabetic Retinopathy Study grid. The glomerular filtration rate (GFR) was determined and CKD was diagnosed (GFR &lt; 60 mL\/min\/1.73 m2). Ninety-six eyes from 52 patients with hypertension were included in this analysis. Twenty patients (n = 37 eyes) were diagnosed with CKD. The mean age was 69 \u00b1 11.7 years and 60.4 \u00b1 9.2 years in the CKD group and in the control group, respectively. The univariate model revealed a significant difference in VD between patients without and with CKD in the superficial IR (0.36 \u00b1 0.03 vs. 0.34 \u00b1 0.04, p = 0.03), the superficial OR (0.35 \u00b1 0.02 vs. 0.33 \u00b1 0.04, p = 0.02), the deep OR (0.24 \u00b1 0.01 vs. 0.23 \u00b1 0.02, p = 0.003), and the FD in the SVP (1.87 \u00b1 0.01 vs. 1.86 \u00b1 0.02, p = 0.02) and DVP (1.83 \u00b1 0.01 vs. 1.82 \u00b1 0.01, p = 0.006). After adjusting for age and sex, these differences did not remain statistically significant. Similar results were observed for the FD in the SVP and DVP. In our cohort, patients with hypertension and CKD did not differ from patients without CKD in regard to microvascular perfusion status in the macular area as assessed using OCTA.<\/jats:p>","DOI":"10.3390\/jcm12175493","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T10:23:40Z","timestamp":1692872620000},"page":"5493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Macular Microvascular Perfusion Status in Hypertensive Patients with Chronic Kidney Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0233-359X","authenticated-orcid":false,"given":"Heiko","family":"Stino","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"de Llano Pato","sequence":"additional","affiliation":[{"name":"Vienna Reading Center, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7768-0417","authenticated-orcid":false,"given":"Irene","family":"Steiner","sequence":"additional","affiliation":[{"name":"Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaus","family":"Mahnert","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Pawloff","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Hasun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinic Land Strasse, Vienna Healthcare Group, 1030 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz","family":"Weidinger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinic Land Strasse, Vienna Healthcare Group, 1030 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Schmidt-Erfurth","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Pollreisz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"ref_1","unstructured":"National Kidney Foundation (2002). K\/DOQI Clinical Practice Guidelines for chronic Kidney Disease: Evaluation, Classification, and Stratification. Am. J. Kidney Dis., 39, S1\u2013S266."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1681\/ASN.V133806","article-title":"Role of the microvascular endothelium in progressive renal disease","volume":"13","author":"Kang","year":"2002","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.2215\/CJN.10291110","article-title":"The microvasculature in chronic kidney disease","volume":"6","author":"Ooi","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Paterson, E.N., Ravindran, M.L., Griffiths, K., Le Velly, C.A., Cardwell, C.C., McCarter, R.V., Nicol, P., Chhablani, J.K., Rasheed, M.A., and Vupparaboina, K.K. (2020). Association of reduced inner retinal thicknesses with chronic kidney disease. BMC Nephrol., 21.","DOI":"10.1186\/s12882-019-1679-1"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1053\/j.ajkd.2010.11.025","article-title":"Bidirectional association of retinal vessel diameters and estimated GFR decline: The beaver dam CKD study","volume":"57","author":"Sabanayagam","year":"2011","journal-title":"Am. J. Kidney Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.1016\/S2589-7500(20)30063-7","article-title":"A deep learning algorithm to detect chronic kidney disease from retinal photographs in community-based populations","volume":"2","author":"Sabanayagam","year":"2020","journal-title":"Lancet Digit. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1093\/ndt\/gfq007","article-title":"Fractal analysis of the retinal vasculature and chronic kidney disease","volume":"25","author":"Sng","year":"2010","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1053\/j.ajkd.2011.02.382","article-title":"Retinal arteriolar narrowing and subsequent development of CKD stage 3: The multi-ethnic study of atherosclerosis (MESA)","volume":"58","author":"Yau","year":"2011","journal-title":"Am. J. Kidney Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1097\/HJH.0b013e328330141d","article-title":"Retinal arteriolar narrowing increases the likelihood of chronic kidney disease in hypertension","volume":"27","author":"Sabanayagam","year":"2009","journal-title":"J. Hypertens."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1161\/CIRCIMAGING.108.784876","article-title":"Retinal vascular imaging: A new tool in microvascular disease research","volume":"1","author":"Liew","year":"2008","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1038\/ki.2013.491","article-title":"Kidney and eye diseases: Common risk factors, etiological mechanisms, and pathways","volume":"85","author":"Wong","year":"2014","journal-title":"Kidney Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1167\/iovs.05-1539","article-title":"Retinal vascular caliber, cardiovascular risk factors, and inflammation: The Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"47","author":"Tien","year":"2006","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1167\/iovs.03-1390","article-title":"Are retinal arteriolar or venular diameters associated with markers for cardiovascular disorders? The Rotterdam study","volume":"45","author":"Ikram","year":"2004","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1001\/archopht.126.10.1404","article-title":"Relative importance of systemic determinants of retinal arteriolar and venular caliber: The atherosclerosis risk in communities study","volume":"126","author":"Liew","year":"2008","journal-title":"Arch. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1038\/eye.2008.362","article-title":"Quantitative retinal vascular calibre changes in diabetes and retinopathy: The Singapore Malay eye study","volume":"23","author":"Islam","year":"2009","journal-title":"Eye"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2970","DOI":"10.1167\/iovs.13-11941","article-title":"Structural changes in the retinal microvasculature and renal function","volume":"54","author":"Lim","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1007\/s00125-014-3317-6","article-title":"Retinal vascular fractals predict long-term microvascular complications in type 1 diabetes mellitus: The Danish Cohort of Pediatric Diabetes 1987 (DCPD1987)","volume":"57","author":"Broe","year":"2014","journal-title":"Diabetologia"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e848","DOI":"10.1111\/aos.14395","article-title":"Retinal neurovascular changes in chronic kidney disease","volume":"98","author":"Wu","year":"2020","journal-title":"Acta Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1136\/bjophthalmol-2019-315450","article-title":"Association of renal function with retinal vessel density in patients with type 2 diabetes by using swept-source optical coherence tomographic angiography","volume":"104","author":"Wang","year":"2020","journal-title":"Br. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1167\/iovs.61.8.42","article-title":"Retinal neurovascular impairment in patients with essential hypertension: An optical coherence tomography angiography study","volume":"61","author":"Peng","year":"2020","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1056\/NEJMoa1114248","article-title":"Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin C","volume":"367","author":"Inker","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Yu, S., and Lakshminarayanan, V. (2021). Fractal dimension and retinal pathology: A meta-analysis. Appl. Sci., 11.","DOI":"10.3390\/app11052376"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1161\/HYPERTENSIONAHA.113.01414","article-title":"Hypertensive retinopathy and risk of stroke","volume":"62","author":"Ong","year":"2013","journal-title":"Hypertension"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1001\/archophthalmol.2012.1800","article-title":"Retinopathy and chronic kidney disease in the Chronic Renal Insufficiency Cohort (CRIC) study","volume":"130","author":"Grunwald","year":"2012","journal-title":"Arch. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2469","DOI":"10.1097\/01.ASN.0000136133.28194.E4","article-title":"Retinal microvascular abnormalities and renal dysfunction: The Atherosclerosis Risk in Communities Study","volume":"15","author":"Wong","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e669","DOI":"10.1111\/aos.14670","article-title":"Albuminuria and retinal vessel density in diabetes without diabetic retinopathy: The Kailuan Eye Study","volume":"99","author":"Wang","year":"2021","journal-title":"Acta Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4830","DOI":"10.1167\/iovs.19-28137","article-title":"Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study","volume":"60","author":"You","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hua, D., Xu, Y., Zeng, X., Yang, N., Jiang, M., Zhang, X., Yang, J., He, T., and Xing, Y. (2020). Use of optical coherence tomography angiography for assessment of microvascular changes in the macula and optic nerve head in hypertensive patients without hypertensive retinopathy. Microvasc. Res., 129.","DOI":"10.1016\/j.mvr.2019.103969"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/02713683.2020.1775260","article-title":"Retinal Microvascular Changes in Hypertensive Patients with Different Levels of Blood Pressure Control and without Hypertensive Retinopathy","volume":"46","author":"Hua","year":"2021","journal-title":"Curr. Eye Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1038\/s41440-020-00583-0","article-title":"Morphological changes in and quantitative analysis of macular retinal microvasculature by optical coherence tomography angiography in hypertensive retinopathy","volume":"44","author":"Liu","year":"2021","journal-title":"Hypertens. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1038\/eye.1990.33","article-title":"The fractal properties of retinal vessels: Embryological and clinical implications","volume":"4","author":"Mainster","year":"1990","journal-title":"Eye"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"4940","DOI":"10.1167\/iovs.16-19656","article-title":"Fractal dimensional analysis of optical coherence tomography angiography in eyes with diabetic retinopathy","volume":"57","author":"Zahid","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1167\/iovs.18-25864","article-title":"Age-related alterations in retinal tissue perfusion and volumetric vessel density","volume":"60","author":"Lin","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3492","DOI":"10.1167\/iovs.19-26848","article-title":"Effects of age on peripapillary and macular vessel density determined using optical coherence tomography angiography in healthy eyes","volume":"60","author":"Jo","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2758","DOI":"10.1681\/ASN.2007040422","article-title":"Age affects outcomes in chronic kidney disease","volume":"18","author":"Choi","year":"2007","journal-title":"J. Am. Soc. Nephrol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5493\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:38:08Z","timestamp":1760128688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,24]]},"references-count":35,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12175493"],"URL":"https:\/\/doi.org\/10.3390\/jcm12175493","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,24]]}}}