Short-Term Effect of Angiotensin Converting Enzyme Inhibitor on Choroidal VascularityAngiotensin-converting enzyme (ACE) inhibitors are a group of drugs used primarily for the treatment of elevated blood pressure. They inhibit the activity of ACE, an important component of the renin-angiotensin system which converts angiotensin I to angiotensin II and breaks down bradykinin. Angiotensin II causes constriction of arterioles and venules, inhibits the reuptake of norepinephrine, stimulates the release of catecholamines, and hypertrophy of vascular smooth muscle cells. Another hypothesis is that ACE inhibitors interfere with the degradation of bradykinin, a peptide that causes vasodilation. Therefore, ACE inhibitors decrease the formation of angiotensin II, a vasoconstrictor, and increase the level of bradykinin, a peptide vasodilator

Photodiagnosis Photodyn Ther. 2021 Oct 3:102569. doi: 10.1016/j.pdpdt.2021.102569. Online ahead of print.

ABSTRACT

PURPOSE: To determine the effect of angiotensin-converting enzyme (ACE) inhibitors on choroidal vascularity using the binarization method in a group of treatment-naïve hypertensive patients.

METHODS: There were 48 treatment-naive hypertensive patients who were diagnosed according to the “2013 European Society of Hypertension/European Society of Cardiology” guideline and started angiotensin-converting enzyme inhibitor perindopril (Coversyl) in the study. As a control group, 48 healthy volunteers were randomly selected among people who attended the outpatient clinic for routine ophthalmological examination. Enhanced-depth imaging optical coherence tomography (EDI-OCT) images were captured at baseline and at 1 month after treatment. Binarization of the EDI-OCT images was performed by Image-J software. The choroidal thickness (CT), total choroidal area, luminal area, stromal area, and choroidal vascularity index (CVI) were measured.

RESULTS: There was a statistically significant increase in CT at all locations (subfoveal, nasal, and temporal) at 1 month after treatment compared with baseline (for all, p˂0.001). Choroidal structural parameters and the mean CVI were statistically significantly increased at 1 month after treatment (for all, p˂0.001). When compared, there was no statistically significant difference for the vascular parameters between the control group and the patient group at 1 month (for all, p>0.05).

CONLUSION: A statistically significant improvement was demonstrated in the choroidal vascular parameters except for the stromal area after treating with an ACE inhibitor in a group of hypertensive patients.

PMID:34614428 | DOI:10.1016/j.pdpdt.2021.102569