Choriocapillaris Non-Perfusion in Children With Stage 1 Primary Hypertension

Overview

In a prospective cross-sectional study of 94 children with stage 1 primary hypertension and 60 controls, OCTA showed a greater proportion of non-perfused choriocapillaris area (NPCA) in the hypertensive group across all three measured regions. Other reported retinal, choroidal, and optic nerve measurements were similar between groups, and the children had no clinically detectable ocular disease. The authors note that longitudinal studies are needed to clarify the timing and significance of these findings.

Background

Hypertensive retinopathy is a recognized manifestation of hypertension-related ocular damage. The study authors examined whether OCT and OCTA measurements differed in children with stage 1 primary hypertension who had no clinically detectable ocular disease. OCT and OCTA can assess ocular structures and vascular features, including choriocapillaris perfusion.

Data Highlights

Key Findings

• The study included 94 children aged 6–18 years with stage 1 primary hypertension and 60 age- and sex-comparable healthy controls; hypertensive participants had been followed for at least one year and were not receiving antihypertensive treatment at enrollment.
• All participants had best-corrected visual acuity of 0.00 logMAR, and the report describes no abnormalities on intraocular pressure measurement or anterior and posterior segment examination.
• NPCA was higher in the hypertensive group in all three regions: 12.3% versus 8.7% within 0.5 mm, 14.5% versus 10.2% at 0.5–1.5 mm, and 16.8% versus 12.1% at 1.5–3 mm; each difference was statistically significant.
• Conventional OCT measures and the reported superficial and deep retinal plexus, foveal avascular zone, and optic nerve head OCTA measures did not differ significantly between groups.
• After adjustment for age, sex, and BMI, hypertension remained independently associated with increased NPCA in the 0.5–1.5 mm and 1.5–3 mm regions; BMI was not independently associated with NPCA.
• The authors identify limitations including the cross-sectional design, absence of longitudinal and detailed ambulatory blood-pressure data, unmeasured axial length, lack of pediatric-specific validation of the automated NPCA algorithm, and possible residual metabolic confounding.

Clinical Implications

The study authors state that larger longitudinal cohort studies are needed to clarify the temporal relationship between choriocapillaris changes and systemic hypertension. The supplied context does not establish OCTA-derived NPCA as a validated screening test or describe a formal pediatric recommendation for retinal imaging.

Conclusion

In this pediatric cross-sectional study, increased choriocapillaris NPCA was the principal ocular measurement associated with hypertension, while clinical examinations and several other OCT/OCTA measures were similar between groups. Its timing and clinical significance remain to be established in longitudinal research.

Related Resources & Content

1. BMC Ophthalmology, 2026 — Increased choriocapillaris non-perfusion in pediatric hypertension assessed by optical coherence tomography angiography (OCTA)
2. Increased choriocapillaris non-perfusion in pediatric hypertension assessed by optical coherence tomography angiography (OCTA) | BMC Ophthalmology
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6. Application of Optical Coherence Tomography Angiography Macular Analysis for Systemic Hypertension. A Systematic Review and Meta-analysis | American Journal of Hypertension | Oxford Academic