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Arterial hypertension and retinal layer thickness: the Beijing Eye Study
  1. Hui Xie1,
  2. Zhe Pan2,3,
  3. Can Can Xue2,3,
  4. Danny Chen4,
  5. Jost B Jonas2,5,6,7,
  6. Xiaodong Wu1,8,
  7. Ya Xing Wang2
  1. 1 Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
  2. 2 Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
  3. 3 Department of Ophthalmology, Peking University Third Hospital, Beijing, China
  4. 4 Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, Indiana, USA
  5. 5 Ruprecht-Karls-University Heidelberg, Seegartenklinik Heidelberg, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
  6. 6 Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany
  7. 7 Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
  8. 8 Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA
  1. Correspondence to Dr. Ya Xing Wang, Department of Electrical and Computer Engineering, Beijing Institute of Ophthalmology, Beijing, Beijing 100005, China; yaxingw{at}; Dr. Xiaodong Wu; xiaodong-wu{at}


Purpose To investigate relationships between blood pressure and the thickness of single retinal layers in the macula.

Methods Participants of the population-based Beijing Eye Study, free of retinal or optic nerve disease, underwent medical and ophthalmological examinations including optical coherence tomographic examination of the macula. Applying a multiple-surface segmentation solution, we automatically segmented the retina into its various layers.

Results The study included 2237 participants (mean age 61.8±8.4 years, range 50–93 years). Mean thicknesses of the retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer, inner nuclear layer (INL), outer plexiform layer, outer nuclear layer/external limiting membrane, ellipsoid zone, photoreceptor outer segments (POS) and retinal pigment epithelium–Bruch membrane were 31.1±2.3 µm, 39.7±3.5 µm, 38.4±3.3 µm, 34.8±2.0 µm, 28.1±3.0 µm, 79.2±7.3 µm, 22.9±0.6 µm, 19.2±3.3 µm and 20.7±1.4 µm, respectively. In multivariable analysis, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with thinner GCL and thicker INL, after adjusting for age, sex and axial length (all p<0.0056). Higher SBP was additionally associated with thinner POS and higher DBP with thinner RNFL. For an elevation of SBP/DBP by 10 mm Hg, the RNFL, GCL, INL and POS changed by 2.0, 3.0, 1.5 and 2.0 µm, respectively.

Conclusions Thickness of RNFL, GCL and POS was inversely and INL thickness was positively associated with higher blood pressure, while the thickness of the other retinal layers was not significantly correlated with blood pressure. The findings may be helpful for refinement of the morphometric detection of retinal diseases.

  • Anatomy
  • Epidemiology
  • Retina

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors Design of the study, assessment of measurements, statistical analysis, revision and final approval of the manuscript: HX, ZP, CCX, DC, JBJ, XW and YXW; Writing of the version draft of the manuscript: HX, ZP, CCX, DC, XW and YXW; Guarantor: YXW

  • Funding This study received funding support from the National Natural Science Foundation of China (#82271086), Beijing Municipal of Health Reform and Development Project (#2019-4) and National Science Foundation of USA (CCF-1733742).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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