Objective:

To quantitatively assess the impact of systemic hypertension and its duration on macular and peripapillary vascular density and FAZ parameters using swept-source OCTA, and to evaluate the functional consequences on visual field indices, highlighting the significance of these findings in the context of existing literature.

Key Findings:

• Significant reductions in OCTA-derived vessel density across SCP, DCP, CC, and RPC in hypertensive patients, indicating potential risks for visual impairment.
• Enlargement of FAZ parameters associated with longer duration of hypertension, suggesting a progressive vascular compromise.
• Correlations between structural changes in OCTA findings and visual field indices, emphasizing the need for regular monitoring.

Interpretation:

The study suggests that systemic hypertension adversely affects retinal microvasculature and visual function, highlighting the importance of OCTA as a noninvasive biomarker for monitoring hypertensive end-organ damage and its potential clinical applications.

Limitations:

• Small sample size may limit generalizability and introduce potential biases.
• Short duration of follow-up may not capture long-term effects, necessitating further studies.

Conclusion:

Understanding the microvascular consequences of systemic hypertension in the retina and optic nerve head is crucial for early detection and management of ocular complications, reinforcing the need for proactive monitoring in clinical practice.