@article{article_1939863, title={Hypertension-Related Microstructural Changes in the Vitreous Humor Detected by Diffusion MRI}, journal={Istanbul Gelisim University Journal of Health Sciences}, pages={445–462}, year={2026}, DOI={10.38079/igusabder.1939863}, url={https://izlik.org/JA48ZJ47CG}, author={Çapkan, Davut Ünsal}, keywords={Hypertension, ocular microstructure, vitreous humor, imaging biomarker, apparent diffusion coefficient, diffusion-weighted MRI}, abstract={ Aim: Hypertension is known to affect several target organs through chronic microvascular injury. Although ocular involvement is usually assessed by retinal or choroidal vascular findings, possible changes in the vitreous humor have received limited attention. This study investigated whether diffusion-weighted magnetic resonance imaging (DW-MRI) could detect hypertension-related alterations in the vitreous humor by measuring apparent diffusion coefficient (ADC) values. Method: This retrospective cross-sectional study included 100 patients with hypertension and 100 controls frequency matched to the hypertension group according to age and sex who had undergone orbital DW-MRI. Vitreous humor ADC values were measured on ADC maps using standardized regions of interest (ROI). Right, left, and mean ADC values were compared between groups. Multivariable linear regression was used to determine factors independently associated with mean ADC. Within-sample discriminative performance was explored using receiver operating characteristic (ROC) analysis. Intra-observer reliability was evaluated with intraclass correlation coefficients. Results: Mean vitreous ADC was significantly lower in participants with hypertension than in controls (2.18±0.20 vs. 2.32±0.18 ×10⁻³ mm²/s; p<0.001), with a moderate-to-large effect size (Cohen’s d=0.72). In multivariable analysis, hypertension remained independently associated with lower mean ADC after adjustment for age, sex, and diabetes mellitus (B=−0.160, 95% CI: −0.210 to −0.110; standardized β=−0.42; p<0.001). Mean ADC showed the highest within-sample discrimination among the evaluated measures (AUC=0.83, 95% CI: 0.77–0.89), with a data-derived cut-off of ≤2.25 ×10⁻³ mm²/s, 78.0% sensitivity, and 75.0% specificity. Age was inversely correlated with mean ADC (r=−0.34, p<0.001). Intra-observer reproducibility was excellent for mean ADC measurements (ICC=0.96, 95% CI: 0.94–0.97). Conclusion: Patients with hypertension had lower vitreous ADC values than controls, which may reflect subtle differences in vitreous microstructure. Although mean ADC showed within-sample discrimination between hypertensive participants and controls, these exploratory findings do not establish vitreous ADC as a clinical diagnostic test. Prospective multicenter studies incorporating comprehensive ophthalmological assessments and external validation are required to clarify the clinical relevance of these findings. }, number={30}