الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Systemic arterial hypertension is defined as a systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. It is a long-term condition in which the blood pressure is persistently elevated. It is an established risk factor of atherosclerosis, ischemic events and with a higher risk of death. It affects one billion people worldwide, and is considered as a major preventable cause of morbidity and mortality. Prescription of antihypertensive drugs to achieve the recommended target blood pressures remains the main step of management of hypertensive patients. Calcium channel blockers and or beta blockers are consider to be the most common line of treatment of hypertension. The primary response of the retinal arterioles to systemic hypertension is vasoconstriction. Sustained hypertension leads to disruption of the inner blood retinal barrier, increased vascular permeability and arteriolosclerosis. The fundus shows focal and generalized arteriolar narrowing, micro-aneurysms, AV nicking as a signs of chronic hypertension. Sustained arterial hypertension affects choroid in the form of Elschnig spots and seigrits streaks. Retinal nerve fiber layer thickness is also affected. Optical coherence tomography (OCT) is a non-invasive ocular imaging technology designed to acquire high resolution cross-sectional retinal images. It has become very important tool in detection retinal, nerve layer and choroidal changes associated with hypertension. The purpose of this study was to evaluate the retinal changes, retinal nerve fiber layer affection and choroidal changes in patients with sustained arterial hypertension on (beta blockers or calcium channel blockers) compared to normotensive control eyes using optical coherence tomography. This cross sectional controlled study carried out on three groups:- group A: included 10 normal individuals (20 eyes) with no systemic hypertension. group B: included 15 patients (30 eyes) with systemic hypertension receiving beta blockers for more than 1 year. group C: included 15 patients (30 eyes) with systemic hypertension receiving calcium channel blockers for more than 1 year Participants were selected from outpatient clinic of ophthalmology department in Tanta University Hospital during the period of one year from October 2020 to September 2021 and any patients with co morbidities e.g diabetes mellitus, glaucoma and other ocular diseases were excluded. Regarding the central macular thickness, our study found that there was significant increase in the central macular thickness from 238.95 ± 11.91 µm of group A (control group) to 274.33 ± 29.82 µm of group B, and increased to 310.07 ± 50.47 µm of group C. There was significant increase between group B and C in comparison to normotensive patients. There were two eyes in two different patients had Is-Os junction interruption due to their history of branch vein occlusion. This study showed that there was decrease in the mean subfoveal choroidal thickness from 247.40±46.18 µm in group A (control group) to 195.63±28.96 µm in group B and decreased to 203.10±27.74 µm in group C. There was statistically significant difference between control group and hypertensive groups. There was no statistically significant difference between group B and group C. As regard retinal nerve fiber layer (RNFL), the current study demonstrated that 40% of group B were within normal limits of thickness and 60% had thinning (33.3% with thinning inferior and 26.7% with thinning superior), and group C had 26.7% within normal limits of thickness and 73.3% had thinning (33.3% with thinning inferior,13.3% with thinning superior and 26.7% borderline). There were statistically significant difference between the two hypertensive groups.