Hypertension-Associated Anisometropia: Interocular Choroidal and Macular Asymmetry as Potential Mediators

Abstract

PurposeThis study aimed to investigate the association between hypertension and anisometropia and determine whether interocular structural asymmetry mediates this relationship.

MethodsIn this cross-sectional study, nationally representative samples from the US (N = 12,749; NHANES 1999-2008) and Korea (N = 35,484; KNHANES 2008-2024) were analyzed. Associations between hypertension, blood pressure components (BPC), and anisometropia were examined using weighted multivariable logistic regression and restricted cubic splines. Mediation analysis assessed whether asymmetry in optical coherence tomography (OCT) structural parameters mediated the association between BPC and anisometropia.

ResultsHypertensive individuals had higher odds of anisometropia in both cohorts (NHANES: OR = 1.32, 95% CI: 1.12-1.56, P = 0.001; KNHANES: OR = 1.12, 95% CI: 1.05-1.20, P < 0.001). Each 10 mmHg increase in systolic blood pressure (SBP) and pulse pressure (PP) was associated with 5% and 10% greater risk, respectively. Interocular differences in central macular and choroidal thickness partially mediated the association between BPCs and anisometropia. Time-course bulk RNA-seq identified Rock1 as a candidate gene downregulated under hypertensive conditions.

ConclusionsHypertension was associated with anisometropia across two national cohorts. Interocular differences in central macular and choroidal thickness partially mediated this association, suggesting a link between systemic hemodynamic alterations and ocular structural asymmetry.

Translational RelevanceThese findings suggest that interocular OCT structural asymmetry may serve as a clinically accessible imaging biomarker to identify individuals at increased risk of hypertension-associated anisometropia.

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BibTeX RIS

BibTeX

@misc{bao2026hypertensionassociated,
  title = {{Hypertension-Associated Anisometropia: Interocular Choroidal and Macular Asymmetry as Potential Mediators}},
  author = {R. Bao and W. Zhang and S. Lin and M. Lin},
  howpublished = {medRxiv},
  year = {2026},
  month = sep,
  doi = {10.64898/2026.09.26.26364065},
  url = {https://www.medrxiv.org/content/10.64898/2026.09.26.26364065v1},
  note = {CC BY-NC-ND},
}

RIS

TY  - UNPB
TI  - Hypertension-Associated Anisometropia: Interocular Choroidal and Macular Asymmetry as Potential Mediators
AU  - R. Bao
AU  - W. Zhang
AU  - S. Lin
AU  - M. Lin
PY  - 2026
DA  - 2026/09/26
PB  - medRxiv
DO  - 10.64898/2026.09.26.26364065
UR  - https://www.medrxiv.org/content/10.64898/2026.09.26.26364065v1
AB  - PurposeThis study aimed to investigate the association between hypertension and anisometropia and determine whether interocular structural asymmetry mediates this relationship.  MethodsIn this cross-sectional study, nationally representative samples from the US (N = 12,749; NHANES 1999-2008) and Korea (N = 35,484; KNHANES 2008-2024) were analyzed. Associations between hypertension, blood pressure components (BPC), and anisometropia were examined using weighted multivariable logistic regression and restricted cubic splines. Mediation analysis assessed whether asymmetry in optical coherence tomography (OCT) structural parameters mediated the association between BPC and anisometropia.  ResultsHypertensive individuals had higher odds of anisometropia in both cohorts (NHANES: OR = 1.32, 95% CI: 1.12-1.56, P = 0.001; KNHANES: OR = 1.12, 95% CI: 1.05-1.20, P < 0.001). Each 10 mmHg increase in systolic blood pressure (SBP) and pulse pressure (PP) was associated with 5% and 10% greater risk, respectively. Interocular differences in central macular and choroidal thickness partially mediated the association between BPCs and anisometropia. Time-course bulk RNA-seq identified Rock1 as a candidate gene downregulated under hypertensive conditions.  ConclusionsHypertension was associated with anisometropia across two national cohorts. Interocular differences in central macular and choroidal thickness partially mediated this association, suggesting a link between systemic hemodynamic alterations and ocular structural asymmetry.  Translational RelevanceThese findings suggest that interocular OCT structural asymmetry may serve as a clinically accessible imaging biomarker to identify individuals at increased risk of hypertension-associated anisometropia.
ER  -

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