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Erkan Pota Ç, Doğan ME, Alkan Bülbül G, Sanhal CY, Pota A. Optical coherence tomography angiography assessment of retinochoroidal microcirculation differences in preeclampsia. Photodiagnosis Photodyn Ther 2024; 46:104004. [PMID: 38342388 DOI: 10.1016/j.pdpdt.2024.104004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/14/2024] [Accepted: 02/05/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND To investigate microvascular changes in pregnant women with preeclampsia using optical coherence tomography angiography (OCTA) and compare the results with healthy pregnant and non-pregnant subjects. METHODS Superficial capillary plexus (SCP), deep capillary plexus (DCP) choriocapillaris (CC) vessel density (VD) and foveal avascular zone area (FAZ), retina, retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL) and the choroidal thickness were examined and compared in preeclamptic pregnant (group 1), healthy pregnant women (group 2) and non-pregnant, age-matched female controls (group 3). The correlations of the parameters with each other and with blood pressure were evaluated. RESULTS No significant difference was found between the groups when retinal, RNFL and GCL thickness values (p> 0.05). The choroidal thickness values were significantly lower in group 1 than in group 2 (p = 0.029). The central foveal VD of the SCP and DCP was significantly lower in group 1 compared to groups 2 and 3 (p = 0.03, p< 0.01 respectively). The mean VD of the SCP was significantly higher in groups 1 and 2 than in group 3 (p = 0.01). The FAZ area was statistically significantly lower in group 3 than in group 2 (p = 0.032). The CC VD was lower in group 3 compared to the other groups in all measurements (p < 0.01).The FAZ area was positively correlated with systolic blood pressure in group 1. CONCLUSION The use of OCTA, a non-invasive imaging technique, to assess the retinal microcirculation appears to have the potential to in the early diagnosis or follow up in preeclampsia before signs of hypertensive retinopathy.
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Affiliation(s)
- Çisil Erkan Pota
- Department of Ophthalmology, Manavgat State Hospital, Antalya, Turkey.
| | - Mehmet Erkan Doğan
- Department of Ophthalmology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Gül Alkan Bülbül
- Department of Obstetrics and Gynecology, Division of Perinatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Cem Yaşar Sanhal
- Department of Obstetrics and Gynecology, Division of Perinatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Ali Pota
- Department of Obstetrics and Gynecology, Antalya Kepez State Hospital, Antalya, Turkey
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Doğan ME, Erkan Pota Ç. Investigation of the effects of gestational diabetes and hypertension on retinal and choroidal microvascular circulation using swept-source optical coherence tomography angiography. Microvasc Res 2024; 152:104622. [PMID: 37981229 DOI: 10.1016/j.mvr.2023.104622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE The aim of this study was to investigate the microvascular changes in the retina and choroid in gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) and to compare the results with those of healthy pregnant subjects. METHODS Twenty-nine pregnant subjects with coexisting GDM and PIH (group 1) and 36 healthy pregnant subjects (group 2) were enrolled in the study. All subjects were examined by optical coherence tomography (OCT) and angiography (OCTA). The retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), choroidal thickness (CT), superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) vascular density (VD), and foveal avascular zone (FAZ) were measured. RESULTS We observed that the values of CT and VD were lower in group 1 than in group 2. No significant difference was found between groups in RT, FAZ area and CC VD. SCP and DCP VD values were higher in group 2 in all quadrants. We observed a significant increase in FAZ area and CC VD with increasing systolic blood pressure. No correlation was observed between diastolic blood pressure and FBS with other parameters. In group 1, FAZ area was significantly higher in the diet-treated group than in the insulin-treated group. CONCLUSION Monitoring and treatment of pregnant women with PIH and GDM is important because of the risks that may occur during pregnancy. We believe that changes in microvascular circulation can be detected noninvasively with OCTA, even in the absence of clinical or retinal findings.
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Affiliation(s)
- Mehmet Erkan Doğan
- Department of Ophthalmology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Çisil Erkan Pota
- Department of Ophthalmology, Manavgat State Hospital, Antalya, Turkey.
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Wu H, Lin H, Ruan M, Fang H, Dong N, Wang T, Yu F, Zhao J. Evaluation of choroidal thickness and retinal nerve fiber layer thickness in Chinese pregnant women and healthy non-pregnant women. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:8-13. [PMID: 38204803 PMCID: PMC10776912 DOI: 10.1016/j.aopr.2023.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024]
Abstract
Purpose To evaluate choroidal thickness and retinal nerve fiber layer (RNFL) thickness in different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods A prospective comparative study included 45 healthy pregnant women in the first trimester, 45 women in the second, 45 women in the third and 45 healthy non-pregnant women as the control group. Macular choroidal thickness was measured at three locations: The subfoveal, 1 mm temporal, and 1 mm nasal from the fovea with EDI-OCT. Peripapillary choroidal thickness (PPCT) and RNFL thickness parameters were automatically calculated by the Spectralis OCT. Results The subfoveal, temporal and nasal macular choroidal thickness were all significantly thicker in the second trimester, compared with those parameters in the first, the third trimesters and the control group (all P < 0.05). The PPCT was significantly increased in the second trimeter compared with the control group at global, temporal, temporal inferior, nasal and nasal inferior positions (all P < 0.05). The RNFL thickness was also significantly increased in pregnant women at nasal superior and nasal inferior quadrants (all P < 0.05). Conclusions The choroidal thickness in pregnant women was found to be thicker than the control group, regardless of macular or optic disc location. Findings of RNFL thickening might indicate subclinical involvement of the central nervous system.
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Affiliation(s)
- Hanfei Wu
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Haishuang Lin
- Department of Opthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengting Ruan
- Department of Obstetrics, The People's Hospital of Zhuji, Zhejiang, China
| | - Huanjie Fang
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Nannan Dong
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Tiewei Wang
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Feifei Yu
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Jiawei Zhao
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
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Wu H, Lin H, Ruan M, Fang H, Dong N, Wang T, Yu F, Zhao J. Response to letter to the editor regarding "Is relying on RNFL specific enough to identify any changes in the CNS?". ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:45. [PMID: 38434595 PMCID: PMC10909601 DOI: 10.1016/j.aopr.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Hanfei Wu
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Haishuang Lin
- Department of Opthalmology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mengting Ruan
- Department of Obstetrics, The People's Hospital of Zhuji, Zhejiang, China
| | - Huanjie Fang
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Nannan Dong
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Tiewei Wang
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Feifei Yu
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
| | - Jiawei Zhao
- Department of Opthalmology, The People's Hospital of Zhuji, Shaoxing, Zhejiang, China
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Su S, Zhong H, Wang X, Huang Y, Su Q. Shear wave elastography combined with two-dimensional ultrasonography for detecting optic nerve sheath: An effective tool for assessing preeclampsia. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1412-1418. [PMID: 37643987 DOI: 10.1002/jcu.23551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE/OBJECTIVE This study aimed to investigate two-dimensional ultrasound and shear-wave elastography (SWE) in evaluating optic neuropathy in preeclampsia. METHODS Ninety-one singleton pregnant women (51 with preeclampsia [observation group]; 40 without complications [control group]) admitted between January 2022 and April 2022 participated in this study. Optic nerve sheath diameter (ONSD) and optic nerve stiffness measurement (ONSM) were measured using two-dimensional ultrasound and SWE, respectively, and compared between the two groups. Receiver operating characteristic curves were employed to evaluate the performance of ONSD, ONSM, and combination (ONSD + ONSM) for diagnosing preeclampsia. RESULTS The observation (preeclampsia) group ONSD and ONSM were significantly higher than those in the control group (p < 0.05). Optimal diagnostic values for ONSD and ONSM were 4.10 mm and 11.20 kPa, respectively. Areas under the curve for diagnosing preeclampsia were 0.958 (95% confidence interval [CI], 0.926-0.990) for ONSD, 0.939 (95% CI, 0.894-0.985) for ONSM, and 0.982 (95% CI, 0.962-1.000) for ONSD + ONSM. There was no significant difference between ONSD and ONSM in diagnosing preeclampsia (p = 0.436). However, ONSD + ONSM was significantly advantageous over ONSD or ONSM alone in diagnosing preeclampsia (p = 0.033; p = 0.014). CONCLUSIONS Ultrasonic evaluation of the optic nerve can quantitatively assess optic nerve changes in pregnant women with preeclampsia.
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Affiliation(s)
- Shanshan Su
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Huohu Zhong
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Xiaohua Wang
- Department of Anesthesiology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yanyan Huang
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
- Department of Reproductive in Medicine, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qichen Su
- Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Kim IK, Shin JE, Kim MJ, Ra H, Baek J. Quantitative analysis of choroidal morphology in preeclampsia during pregnancy according to retinal change. Sci Rep 2023; 13:13171. [PMID: 37580383 PMCID: PMC10425443 DOI: 10.1038/s41598-023-40144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/05/2023] [Indexed: 08/16/2023] Open
Abstract
We sought to investigate changes in choroidal hemodynamics in preeclampsia according to presence of retinal change by quantitatively assessing choroidal vessels using optical coherence tomography (OCT). This retrospective study included 106 eyes (of 53 patients) with preeclampsia, including 70 eyes without retinal change in patients with preeclampsia (Group A), 22 eyes with retinal change in patients with preeclampsia (Group B), and 14 eyes of normal pregnant women (controls). Subfoveal choroidal thickness (SFCT) was measured on OCT B-scan images, and choroidal vessel densities (CVDs) were calculated using binarized OCT B-scan and en face images. Their values were then correlated with clinical parameters associated with preeclampsia. SFCT was greater in Group B compared to Group A or controls (354.32 ± 65.13 vs. 288 ± 55.68 or 277.21 ± 50.08, both P < 0.001). CVD on B-scan images was greater in Group B compared to Group A or controls (76.4 ± 4.9 vs. 73.7 ± 5.3 or 71.5 ± 5.1; both P ≤ 0.046). CVD on en face images was also greater in Group B compared to Group A or controls (64.7 ± 0.8 vs. 63.6 ± 1.5 or 63.3 ± 1.3; both P ≤ 0.001). SFCT and CVD positively correlated with each other (P ≤ 0.009) and were greater in patients with blurred vision and vaginal bleeding (P ≤ 0.020 for blurred vision and P ≤ 0.024 for vaginal bleeding). SFCT and CVDs were higher in preeclampsia patients with retinal change compared to those without retinal change or controls. Both SFCT and CVD showed association with blurred vision and vaginal bleeding.
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Affiliation(s)
- In Kee Kim
- Department of Ophthalmology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, #327 Sosa-Ro, Wonmi-Gu, Bucheon, Gyeonggi-Do, 14647, Republic of Korea
| | - Jae Eun Shin
- Department of Obstetrics and Gynecology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-Do, Republic of Korea
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min Jeong Kim
- Department of Obstetrics and Gynecology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Gyeonggi-Do, Republic of Korea
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Ra
- Department of Ophthalmology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, #327 Sosa-Ro, Wonmi-Gu, Bucheon, Gyeonggi-Do, 14647, Republic of Korea
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jiwon Baek
- Department of Ophthalmology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, #327 Sosa-Ro, Wonmi-Gu, Bucheon, Gyeonggi-Do, 14647, Republic of Korea.
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Ohkuma M, Maruyama T, Ishii T, Igarashi N, Azuma K, Inoue T, Obata R, Miyachi EI, Kaneda M. Effects of Progesterone and Other Gonadal Hormones on Glutamatergic Circuits in the Retina. J NIPPON MED SCH 2023; 90:333-345. [PMID: 37690823 DOI: 10.1272/jnms.jnms.2023_90-405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Gonadal hormones function in the retina; however, their targets have not yet been identified. Therefore, the present study examined the effects of progesterone and other gonadal hormones on glutamatergic circuits in the retina. METHODS Extracellular glutamate concentrations, which correspond to the amount of glutamate released, were examined using an enzyme-linked fluorescent assay system. The activity of glutamatergic synapses between bipolar cells and ganglion cells was investigated using a patch clamp technique. Changes in retinal thickness during pregnancy were assessed using optical coherence tomography (OCT) images. RESULTS Progesterone and pregnenolone sulfate increased extracellular glutamate concentrations, whereas estrogen and testosterone did not. Progesterone increased the activity of glutamatergic synapses between bipolar cells and ganglion cells. A temporal decrease in the thickness of the peripheral retina was observed in the 1st trimester. CONCLUSIONS Progesterone, but not estrogen or testosterone, activated glutamate release in the mouse retina. Increases in the concentration of progesterone during pregnancy did not induce any detectable change in retinal thickness.
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Affiliation(s)
| | - Takuma Maruyama
- Department of Physiology, Nippon Medical School
- Present address: Department of Physiology, Division of Neurophysiology, School of Medicine, Tokyo Women's Medical University
| | | | - Nozomi Igarashi
- Department of Ophthalmology, Faculty of Medicine, Tokyo University
| | - Keiko Azuma
- Department of Ophthalmology, Faculty of Medicine, Tokyo University
| | - Tatsuya Inoue
- Department of Ophthalmology, School of Medicine, Yokohama City University
| | - Ryo Obata
- Department of Ophthalmology, Faculty of Medicine, Tokyo University
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Fayed AE, Thabet MM, Salama MM, El Shazly M. Diminished choroidal blood flow in hypertensive and preeclamptic third trimester pregnancies using optical coherence tomography angiography. PLoS One 2023; 18:e0285884. [PMID: 37200272 DOI: 10.1371/journal.pone.0285884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
PURPOSE The aim of this study was to compare choroidal adjusted flow index (AFI) in healthy, hypertensive & preeclamptic pregnancies using optical coherence tomography angiography (OCTA). METHODS In this prospective study, healthy, hypertensive & preeclamptic third trimester pregnant women underwent OCTA imaging. 3x3 & 6x6 mm choriocapillaris slabs were exported and the parafoveal area was marked by two concentric ETDRS circles at 1 & 3 mm, centered on the foveal avascular zone. Parafoveal AFI was calculated as a parameter of choroidal blood flow. RESULTS Fifteen eyes of fifteen women per group were recruited (45 eyes). AFI was significantly lower in the preeclamptic compared to the healthy & hypertensive groups (Tukey HSD: <0.001 in both groups on 3x3 mm, and 0.02 & 0.04 in 6x6 mm scans), and in the hypertensive compared to the healthy group (0.005 & 0.03 in 3x3 & 6x6 mm scans respectively). CONCLUSIONS Pregnancies complicated with preeclampsia revealed the lowest choroidal blood flow on OCTA followed by pregnancies with systemic hypertension compared to healthy pregnancies. We provide in-vivo documentation of choroidal ischemia, highlighting its culpability in hypertensive and preeclamptic retinochoroidal pathology, and the possibility of utilizing choroidal blood flow on OCTA as a precursor for disease progression.
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Affiliation(s)
- Alaa E Fayed
- Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, Egypt
- Watany Research & Development Center, Watany Eye Hospital, Cairo, Egypt
| | - Mohamed M Thabet
- Department of Obstetrics and Gynecology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, Egypt
| | - Marwa Metwally Salama
- Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, Egypt
| | - Malak El Shazly
- Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, Egypt
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Sequential measurement of the neurosensory retina in hypertensive disorders of pregnancy: a model of microvascular injury in hypertensive emergency. J Hum Hypertens 2023; 37:28-35. [PMID: 34625659 PMCID: PMC9831929 DOI: 10.1038/s41371-021-00617-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/13/2021] [Accepted: 09/24/2021] [Indexed: 01/31/2023]
Abstract
Optical coherence tomography of the eye suggests the retina thins in normal pregnancy. Our objectives were to confirm and extend these observations to women with hypertensive disorders of pregnancy (HDP). Maternal demographics, clinical/laboratory findings and measurements of macular thickness were repeatedly collected at gestational ages <20 weeks, 20-weeks to delivery, at delivery and postpartum. The primary outcome was the change in macular thickness from non-pregnant dimensions in women with incident HDP compared to non-hypertensive pregnant controls. Secondary outcomes were the relationship(s) between mean arterial pressure (MAP) and macular response. Data show macular thicknesses diminished at <20 weeks gestation in each of 27 pregnancies ending in HDP (mean 3.94 µm; 95% CI 4.66, 3.21) and 11 controls (mean 3.92 µm; 5.05, 2.79; P < 0.001 versus non-pregnant dimensions in both; P = 0.983 HDP versus controls). This thinning response continued to delivery in all controls and in 7 women with HDP superimposed on chronic hypertension. Macular thinning was lost after 20 weeks gestation in the other 20 women with HDP. MAP at loss of macular thinning in women without prior hypertension (n = 12) was identical to MAP at enrollment. However, mean MAP subsequently rose 19 mmHg (15, 22) leading to de novo HDP in all 12 women. Loss of thinning leading to a rise in MAP was also observed in 8 of 15 women with HDP superimposed on chronic hypertension. We conclude the macula thins in most women in early pregnancy. Those who lose this early macular thinning response often develop blood pressure elevations leading to HDP.
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Hanhart J, Weill Y, Wasser L, Zadok D, Glick A, Farkash R, Grisaro-Granovsky S, Sela H, Avitan T. Thinning of specific retinal layers as a novel biomarker for adverse outcomes in high-risk pregnancy. J Fr Ophtalmol 2022; 45:1171-1176. [DOI: 10.1016/j.jfo.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/01/2022] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
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Alizadeh Y, Moravvej Z, Soltani-Moghadam R, Dourandeesh M, Akbari M, Azaripour E, Medghalchi A, Sorouri ZZ, Motaghinia Z. Evaluation of Choroidal Thickness during Pregnancy and Postpartum: A Longitudinal Study. J Curr Ophthalmol 2022; 34:312-317. [PMID: 36644463 PMCID: PMC9832460 DOI: 10.4103/joco.joco_42_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/22/2022] [Accepted: 06/12/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose To assess the longitudinal changes of choroidal thickness using enhanced depth imaging optical coherence tomography (EDI-OCT) during pregnancy and postpartum. Methods The study included 23 eyes of 23 healthy pregnant women and 23 eyes of 23 healthy nonpregnant women. Choroidal thickness was measured manually with EDI-OCT at seven locations: The fovea, 500, 1000, and 1500 μm temporal (T) from the fovea and 500, 1000, and 1500 μm nasal (N) from the fovea. Measurements were obtained at each pregnancy trimester and 6 weeks postpartum and in the follicular phase of the menstrual cycle for the control group. Results The mean subfoveal choroidal thickness was 410.2 ± 82.4 μm, 434.8 ± 79.6 μm, 433.5 ± 80.3 μm, and 395.0 ± 71.1 μm in the first, second, and third trimesters and 6 weeks postpartum, respectively. In all seven measured locations, statistically significant changes were noted during pregnancy and postpartum in the choroidal thickness (P < 0.001). Choroidal thickness increased from the first trimester to the second and third trimester, after which it decreased at postpartum. Choroidal thickness was greater in the pregnant group during pregnancy and postpartum compared to the control group (P < 0.001). Conclusions This study indicated significant change in choroidal thickness at seven locations measured with EDI-OCT throughout pregnancy and 6 weeks after delivery. We showed that 6 weeks after delivery, choroidal thickness remains significantly higher than nonpregnant subjects.
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Affiliation(s)
- Yousef Alizadeh
- Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Moravvej
- Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran,Department of Ophthalmology, Hakim Hospital, Neyshabour University of Medical Sciences, Neyshabour, Iran,Address for correspondence: Zahra Motaghinia, Department of Ophthalmology, School of Medicine, Arak University of Medical Sciences, Arak, Iran. E-mail:
| | - Reza Soltani-Moghadam
- Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Dourandeesh
- Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mitra Akbari
- Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ebrahim Azaripour
- Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abdolreza Medghalchi
- Department of Eye, Eye Research Center, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ziba Zahiri Sorouri
- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Alzahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Motaghinia
- Department of Ophthalmology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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THE ROLE OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN PATIENTS WITH PREECLAMPSIA. Retina 2022; 42:1931-1938. [DOI: 10.1097/iae.0000000000003538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Features of vascular-platelet and coagulation hemostasis in relation to parameters of macular blood fl ow in women with preeclampsia. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.6-1.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. Recently, more and more attention has been paid to the development of vascular retinal disorders after suffering preeclampsia. It is noted that the key role in this process is assigned to the systemic endothelial dysfunction that persists for a long time after delivery.Aim: to elucidate the features of vascular-platelet and coagulation hemostasis in relation to the indicators of blood flow in the macular region in women with preeclampsia.Materials and methods. The main group included 45 women with preeclampsia in the third trimester of pregnancy (35–36 weeks). Their age ranged from 19 to 40 years (27 ± 5.2 years). The comparison group was represented by 20 women with physiological pregnancy in the third trimester (35–36 weeks). Their age averaged 26 ± 5.1 years (18–38 years). Somatically healthy non-pregnant women (20 people) were included in the control group. Their age ranged from 19 to 38 years (26 ± 5.4 years). A comparative analysis of the studied parameters of macular blood fl ow, vascular-platelet and coagulation hemostasis between the groups was carried out.Results. When studying the number of platelets in pregnant women, it turned out that in patients with preeclampsia, this indicator was statistically signifi cantly lower compared to the comparison and control groups (p < 0.05). The level of fi brinogen in women with complicated pregnancies was statistically significantly higher than in women with physiological pregnancy and in somatically healthy nonpregnant women (p < 0.05). In addition, retinal microcirculation disorders were observed in women of the main group.Conclusions. The revealed disorders of vascular-platelet and coagulation hemostasis in women during the period of complicated pregnancy were accompanied by disorders of macular blood fl ow in the form of a decrease in the total average density of vessels in the superfi cial vascular plexus, subfoveolar thickness of the choroid and an increase in the area of the avascular zone relative to the group of women with physiological pregnancy and somatically healthy nonpregnant women.
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Relationship between the sFlt-1/PlGF ratio and the optical coherence tomographic features of chorioretina in patients with preeclampsia. PLoS One 2021; 16:e0261287. [PMID: 34882742 PMCID: PMC8659331 DOI: 10.1371/journal.pone.0261287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/26/2021] [Indexed: 01/12/2023] Open
Abstract
This study aimed to evaluate the correlation between ophthalmologic factors and the serologic indicator soluble fms-like tyrosine kinase 1 (sFlt-1): placental growth factor (PlGF) ratio in patients with preeclampsia using optical coherence tomography (OCT) and OCT angiography (OCT-A). A total of 52 pregnant patients (104 eyes) diagnosed with preeclampsia were recruited during their hospital stay. The associations between the sFlt-1/PlGF ratio and chorioretinal measurements, including the choroidal thickness (CT), foveal avascular zone, vascular density, and ganglion cell layer+ were evaluated. Central and nasal subfield CT of the left eye (p = 0.039; p = 0.010) and nasal subfield CT of the right eye (p = 0.042) were lower in the high sFlt-1/PlGF ratio group (≥38). Pearson’s correlation test showed a negative correlation between the sFlt-1/PlGF ratio and central subfield CT; however, this was not statistically significant (p = 0.648). Linear regression analysis revealed a significant association between the sFlt-1/PlGF ratio and central subfield CT (β coefficient, -6.66; p = 0.01) and between sFlt-1 and central subfield CT (β coefficient, -5.65; p = 0.00). Thus, an increase in the sFlt-1/PlGF ratio resulted in a decrease in central subfield CT.
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Liu C, Wei P, Li J. The thickness changes of retina in high myopia patients during the third trimester of pregnancy: a pilot study. BMC Ophthalmol 2021; 21:382. [PMID: 34706696 PMCID: PMC8549153 DOI: 10.1186/s12886-021-02137-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/28/2021] [Indexed: 12/04/2022] Open
Abstract
Objectives To observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women. Methods A case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test. Results Among the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P < 0.05). Compared with the control group, the average thickness of all quadrants of the retina in the parafoveal area except the nasal quadrant were significantly decreased in the study group (P < 0.05). Conclusions In this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.
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Affiliation(s)
- Chenchen Liu
- Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Puying Wei
- Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jun Li
- Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.
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Shim KY, Bae JG, Lee JK, Kim YC. Relationship between proteinuria and optical coherence tomographic features of the chorioretina in patients with pre-eclampsia. PLoS One 2021; 16:e0251933. [PMID: 34015042 PMCID: PMC8136667 DOI: 10.1371/journal.pone.0251933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/05/2021] [Indexed: 11/18/2022] Open
Abstract
This retrospective study aimed to evaluate the correlation between ophthalmologic factors and proteinuria in patients with pre-eclampsia using swept-source optical coherence tomography (OCT) and OCT angiography. In total, 61 pregnant patients diagnosed with pre-eclampsia were recruited during their hospital stay. The authors investigated the relationship between urine protein–creatinine ratio (PCR) and chorioretinal measurements including choroidal thickness (CT), choroidal vascularity index (CVI), foveal avascular zone (FAZ), vascular density (VD), ganglion cell layer+ (GCL+) and GCL++. The associations between mean arterial pressure (MAP) and ophthalmologic factors were also evaluated. Central subfield CT of the right eye (p = 0.031) and paracentral CT of both eyes were related to higher PCR (≥1.35 mg/mg). A significant association with PCR after logarithm transformation was noted (r = 0.284, p = 0.026). Retinal measurements (FAZ, VD, GCL+ and GCL++) and CVI were not related with PCR. There was a positive association between MAP and PCR after logarithm transformation (r = 0.296, p = 0.021); however, chorioretinal factors were not related with MAP. In pregnant women with pre-eclampsia, CT using OCT is a novel factor that is correlated with PCR. Ocular structural alteration in patients with pre-eclampsia may be one of systemic vascular changes caused by pre-eclampsia rather than hypertension.
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Affiliation(s)
- Kyu Young Shim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Jin Gon Bae
- Department of Obstetrics, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Kyoung Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
- * E-mail:
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Stern-Ascher CN, North VS, Garg A, Ananth CV, Wapner RJ, Bearelly S. Subfoveal Choroidal Thickness and Associated Changes of Angiogenic Factors in Women with Severe Preeclampsia. Am J Perinatol 2021; 38:482-489. [PMID: 31683325 PMCID: PMC10895649 DOI: 10.1055/s-0039-1698832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Severe preeclampsia complicates roughly 1% of all pregnancies. One defining feature of severe preeclampsia is new onset visual disturbance. The accessibility of the choroid to high-resolution, noninvasive imaging makes it a reasonable target of investigation for disease prediction, stratification, or monitoring in preeclampsia. This study aimed to compare subfoveal choroidal thickness between women with severe preeclampsia and those with normotensive pregnancies, and to investigate associations between such findings and other indicators of disease severity, including gestational age and serum angiogenic factors. STUDY DESIGN We designed a case-control study comprised of 36 women diagnosed with severe preeclampsia (cases) matched to 37 normotensive women (controls) by race/ethnicity and parity, all diagnosed in the postpartum period. All patients underwent enhanced depth imaging spectral-domain optical coherence tomography and serum analysis. RESULTS Cases showed no difference in subfoveal choroidal thickness compared with controls (p = 0.65). Amongst cases, subfoveal choroidal thickness and gestational age at delivery were inversely related (r = 0.86, p < .001). There was a positive association of placental growth factor with subfoveal choroidal thickness amongst cases (r = 0.54, p = 0.002). CONCLUSION This study suggests a relationship between the degree of disease severity and the magnitude of choroidal thickening. We also show an association between this index and placental growth factor level in the postpartum period.
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Affiliation(s)
- Conrad N Stern-Ascher
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Victoria S North
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Aakriti Garg
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Cande V Ananth
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Epidemiology and Biostatistics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Department of Health Policy and Management, Joseph L. Mailman School of Public Health, Columbia University, New York
- Environmental and Occupational Health Sciences Institute, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Ronald J Wapner
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York
| | - Srilaxmi Bearelly
- Department of Ophthalmology, Vagelos College of Physicians and Surgeons, Columbia University, New York
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Chorioretinal Alterations Induced by Preeclampsia. J Ophthalmol 2021; 2021:8847001. [PMID: 33777446 PMCID: PMC7969093 DOI: 10.1155/2021/8847001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/22/2021] [Accepted: 03/03/2021] [Indexed: 01/22/2023] Open
Abstract
Hypertension during pregnancy, which is essentially a microvascular disease that destroys the end-organ microcirculation, should not be underestimated, as it could lead to organ failure in the kidneys, lungs, and brain. Preassessment of the microcirculatory state through systematic observation of the fundus has been proven to be noninvasive and feasible. Although hypertension in preeclampsia patients will resolve after childbirth, the sticking point is determining the best termination moment. Early diagnosis and treatment can prevent long-term ocular complications and cardiovascular risks for pregnant women in the future. In order to adjust the treatment strategy through more sensitive and precise fundus changes, we comprehensively summarized the common structural changes in the fundus in preeclampsia patients, including changes in the blood vessels, choroid, and retina, as well as the application of quantitative observation for chorioretinal alterations in recent years.
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Assessment of the choroidal structure in pregnant women in the first trimester. Sci Rep 2021; 11:4629. [PMID: 33633327 PMCID: PMC7907119 DOI: 10.1038/s41598-021-84204-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 02/15/2021] [Indexed: 11/17/2022] Open
Abstract
We investigated the anatomical differences in the choroidal structure between pregnant women in the first trimester of pregnancy and age-matched healthy nonpregnant women using enhanced depth imaging optical coherence tomography (EDI-OCT) and choroidal binarization analysis. The main parameters measured in the two study groups, namely, pregnant women in the first trimester and healthy nonpregnant women, were choroidal thickness and the choroidal luminal area. Binarization of the EDI-OCT images from each patient was performed, and the choroidal vascularity index (CVI) was calculated. The correlations between the baseline characteristics of the subjects and the CVI were investigated using linear mixed model analysis. As a result, there was no statistically significant difference in the mean age, best-corrected visual acuity, axial length, central retinal thickness, subfoveal choroidal thickness, systolic blood pressure (BP), or diastolic BP between the two study groups. Conversely, a significant difference was observed in the CVI (P = 0.012) between the two groups. The multivariate analysis identified a significant correlation between the CVI and the systolic BP (P = 0.0044, linear mixed test). Taken together, a larger choroidal luminal area was associated with a higher systolic BP, especially in the first trimester of pregnancy. Our findings may provide further insight into the choroidal changes that occur during pregnancy.
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Hepokur M, Gönen B, Hamzaoğlu K, Tüten A, Sarici AM. Investigation of Retinal Vascular Changes during Pregnancy Using Optical Coherence Tomography Angiography. Semin Ophthalmol 2021; 36:19-27. [PMID: 33566739 DOI: 10.1080/08820538.2021.1884268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: To investigate retinal vascular changes in pregnant women using optical coherence tomography angiography (OCTA).Materials and Methods: This prospective, cross-sectional study included 97 pregnant women and age-matched 34 healthy control subjects. The OCTA parameters of one eye (left) of pregnancy group and control group were compared. Besides, the OCTA parameters of three trimesters were compared between themselves and the control group. The foveal avascular zone (FAZ) area and the vessel density percentages of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillary (RPC) of all the groups were evaluated by OCTA.Results: In the pregnancy group, the vessel density of DCP was higher in all regions than the control group except the foveal region, but this difference could not reach statistical significance. On the other hand, the vessel density of SCP in the pregnancy group did not show a manifest change in all regions except the foveal region as in DCP. Although the FAZ area was wider in pregnancy group, this difference was not statistically significant (p:0.661). There was no statistically significant difference observed in vessel density of SCP, DCP, and RPC between the different trimesters and the control group, and none of these data correlated with the gestational week.Conclusion: This study showed retinal vascular changes secondary to pregnancy, especially in the vessel density of DCP. These results can provide information that should be taken into account in the evaluation and investigation of pregnancy-specific retinal vascular pathologies.
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Affiliation(s)
- Mustafa Hepokur
- Department of Ophthalmology, Istanbul Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey
| | - Busenur Gönen
- Department of Ophthalmology, Istanbul University-Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Kübra Hamzaoğlu
- Department of Obstetrics and Gynecology, Istanbul University-Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Abdullah Tüten
- Department of Obstetrics and Gynecology, Istanbul University-Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Murat Sarici
- Department of Ophthalmology, Istanbul University-Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
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Babu N, Kakkanatt A, Menon B, Rajeev A. Evaluation of retinal changes in normal pregnancy and gestational hypertension – A spectral domain optical coherence tomography based study. KERALA JOURNAL OF OPHTHALMOLOGY 2021. [DOI: 10.4103/kjo.kjo_179_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Yildirim A, Kurt E, Altinisik M, Uyar Y. Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography study. Eur J Ophthalmol 2020; 32:501-507. [PMID: 33081497 DOI: 10.1177/1120672120966566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The structural and vascular changes in the retina and choroid in women in the third trimester of pregnancy were analyzed using optical coherence tomography angiography (OCTA). METHODS Forty women in the third trimester of uncomplicated pregnancy and 40 age-matched healthy women were included. Vascular density (VD) in the superficial and deep capillary plexuses (SCP/DCP), foveal density (FD), and foveal avascular zone (FAZ) area and perimetry measured with OCTA, as well as OCT measurements of central macular thickness (CMT) and choroidal thickness (CT) were compared between the groups. Correlations between structural OCT parameters and vascular OCTA metrics were analyzed. RESULTS The mean gestational age was 34 (28-41) weeks. Mean age was comparable in the groups (p = 0.732). The pregnant women had significantly higher parafoveal DCP-VD (p = 0.015), FAZ area (p = 0.044), and FD (p = 0.002). Mean subfoveal CT was 21 µm higher in pregnant women but was not significant (p = 0.472). There was no difference in CMT (p = 0.448). FAZ metrics were positively correlated with CT in pregnants and with CMT in the control group (p < 0.05). Parafoveal VD was negatively correlated with CT in the control group (p < 0.05). After adjusting for CT and CMT, the significant difference in VD and FD persisted (p < 0.05), while the difference in FAZ area lost significance (p > 0.05). CONCLUSIONS Considering the effects of the probable covariant factors CMT and CT, systemic changes in pregnant women in their third trimester may cause an increase in VD in the macula and parafoveal DCP.
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Affiliation(s)
| | - Emin Kurt
- Ophthalmology Department, Manisa Celal Bayar University, Manisa, Turkey
| | | | - Yildiz Uyar
- Obstetrics and Gynecology Department, Manisa Celal Bayar University, Manisa, Turkey
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Su L, Taweebanjongsin W, Gaw SL, Rabina G, Sadda SR, Tsui I. Evaluation of the Choroid in Women with Uncomplicated Pregnancy. Transl Vis Sci Technol 2020; 9:24. [PMID: 32879780 PMCID: PMC7442858 DOI: 10.1167/tvst.9.9.24] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose To study the choroid in uncomplicated pregnant women using advanced optical coherence tomography (OCT) imaging and analysis. Methods Women with uncomplicated pregnancy in the third trimester (>28 weeks gestational age) and age-matched nonpregnant women were enrolled in this prospective study. All subjects underwent spectral-domain OCT with enhanced depth imaging mode and spectral-domain optical coherent tomography angiography (OCTA). Main outcomes were subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), and choriocapillaris flow deficits (CC FD). Results Twenty-two eyes of 12 uncomplicated pregnant women and 23 eyes of 15 nonpregnant, female controls were included. The mean age was 32.27 ± 6.96 years for the pregnant group and 30.08 ± 5.49 years for control group (P > 0.05). Mean SFCT was 238.70 ± 82.96 µm in the pregnant group, and 277.40 ± 61.79 µm in the control group. CVI was 67.58% ± 2.45% in the pregnant group and 67.31% ± 2.62% in the control group. The CC FD% was 54.06 ± 3.95 in the pregnant group, and 55.02 ± 3.78 in the control group. There was no significant difference between the pregnant and control groups (P > 0.05) in SFCT, CVI or CC FD. Conclusions Although extensive hemodynamic changes occurred with pregnancy, choroidal measurements by OCT and OCTA demonstrated no differences in uncomplicated third-trimester pregnant women compared with nonpregnant controls. Translational Relevance The unaltered choroid in uncomplicated third-trimester pregnancy we described allows clinicians to determine whether abnormal choroidal measurements could be used as a biomarker for complications of pregnancy.
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Affiliation(s)
- Li Su
- Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of medicine, Shanghai, China
| | - Wongsiri Taweebanjongsin
- Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Stephanie L Gaw
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Gilad Rabina
- Department of Ophthalmology, Tel Aviv Sourasky medical Center, affiliated with Sackler School of Medicine, Tel Aviv University, Israel
| | - SriniVas R Sadda
- Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Irena Tsui
- Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Tok A, Beyoğlu A. Antenatal and postpartum comparison of HD-OCT findings of macula, retinal nerve fiber layer, ganglion cell density between severe preeclampsia patients and healthy pregnant woman. Hypertens Pregnancy 2020; 39:252-259. [PMID: 32343154 DOI: 10.1080/10641955.2020.1758938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM To investigate the effects of severe preeclampsia on the retinal nerve fiber layer (RNFL), macula thickness and ganglion cell density in pregnancy and postpartum, using High Definition Optical Coherence Tomography (HD-OCT). MATERIAL AND METHOD The study group included 28 stable pregnant patients diagnosed with severe preeclampsia and the control group, 28 age and gestational week-matched healthy pregnant women. HD-OCT measurements were taken by the same researcher using a Cirrus HD-OCT device and were repeated at 8 weeks postpartum. RESULTS The mean systolic pressure, diastolic pressure, and intraocular perfusion pressure (IPP) values measured in pregnacy were determined to be higher in the preeclampsia group than in the control group (158.4 ± 7.3 vs.113.6 ± 6.8, 97.0 ± 5.7vs.73.8 ± 5.9 and 68.1 ± 3.9 vs.48.8 ± 3.3 mm Hg, respectively) (p < 0.05 for all). The mean RNFL, macula thickness, ganglion cell analysis, and intraocular pressure (IOP) values during pregnancy were determined to be similar in both groups (p > 0.05 for all). No significant difference was determined postpartum between the groups in respect of mean systolic pressure, diastolic pressure, RNFL, macula thickness, ganglion cell analysis, and IOP values (114.3 ± 5.0 vs 114.6 ± 5.9 mm Hg, 74.6 ± 5.1 vs.74.5 ± 5.5 mm Hg, 96.0 ± 7.3 vs. 95.9 ± 6.7 µm, 228.2 ± 18.9 vs.234.5 ± 15.4 µm, 81.8 ± 8.0 vs. 84.2 ± 4.6 µm, 14.1 ± 2.4 vs.13.8 ± 2, respectively) (p < 0.05 for all). Mean IPP during pregnancy was higher than the mean postpartum IPP in the severe pre-eclampsia group (68.1 ± 3.9 vs 49.1 ± 3.1 mm Hg) (p < 0.001). CONCLUSION This is the first study to have evaluated ganglion cell density of the retina, macula thickness, and RNFL using HD-OCT in severe pre-eclampsia cases, both during pregnancy and postpartum.
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Affiliation(s)
- Abdullah Tok
- Department of Obstetrics and Gynecology, Kahramanmaraş Sütçü Imam UniversityHospital , Kahramanmaras, Turkey
| | - Abdullah Beyoğlu
- Department of Ophtalmology, Kahramanmaraş Sütçü Imam UniversityHospital , Kahramanmaras, Turkey
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Abstract
SIGNIFICANCE To our knowledge, this is the first time a study looking at the association between subfoveal choroidal thickness (SFCT) and the parameters affecting the severity of pre-eclampsia has been reported. We provide evidence that SFCT is thicker in pre-eclamptic (PE) patients and speculate on the possible causes. PURPOSE The purposes of this study were to compare SFCT in PE, normal pregnant, and nonpregnant women using spectral domain optical coherence tomography and to correlate SFCT with severity of pre-eclampsia. METHODS A cross-sectional, observational study was performed. A total of 150 participants were divided into three groups: group 1 (50 PE women), group 2 (50 normal pregnant women), and group 3 (50 nonpregnant healthy women). Subfoveal choroidal thickness was measured using spectral domain optical coherence tomography. Other parameters including mean arterial blood pressure (MABP), central corneal thickness, macular thickness, IOP, ocular perfusion pressure (OPP), and urine protein-to-creatinine ratio were also measured. ANOVA and Pearson correlation analysis were used to look at differences between the groups. P < .05 was considered as statistically significant. RESULTS The MABP was higher in group 1 than in groups 2 and 3 (103.0 ± 12.9 vs. 83.2 ± 9.8 vs. 89.5 ± 7.2 mmHg, respectively; all P < .001). The SFCT of the PE group was higher than in groups 2 and 3 (370.7 ± 23.8 vs. 344.5 ± 30.8 vs. 315.8 ± 49.9 μm, respectively; all P < .001). There were no statistically significant differences in central corneal thickness, macular thickness, or IOP between the PE and healthy pregnant groups (all P > .05). The OPP was greater in PE patients (52.8 ± 8.5 vs. 41.9 ± 6.9 vs. 43.4 ± 5.2 mmHg, respectively; both P < .001). The SFCT was positively correlated with MABP (r = 0.464, P < .001), OPP (r = 0.495, P < .001), and urine protein-to-creatinine ratio (r = 0.635, P < .001) in the PE group. CONCLUSIONS Subfoveal choroidal thickness is higher in pre-eclampsia and is proportional to established markers of severity of the condition. This parameter might serve as a novel predictive marker for the severity of pre-eclampsia.
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Alim S, Ozsoy AZ. To Evaluate Choroidal and Retinal Thicknesses in Singleton versus Twin Pregnancies using Optical Coherence Tomography. Middle East Afr J Ophthalmol 2019; 26:153-157. [PMID: 31619903 PMCID: PMC6788317 DOI: 10.4103/meajo.meajo_171_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/24/2019] [Accepted: 09/12/2019] [Indexed: 12/03/2022] Open
Abstract
PURPOSE: The purpose of the study was to evaluate the choroidal and retinal thicknesses in singleton versus twin pregnancies. MATERIALS AND METHODS: This study included 20 single and 20 twin pregnant women in their 3rd trimester with 20 age-matched healthy nonpregnant women as a control group. All participants underwent a detailed ocular examination. Cirrus enhanced depth imaging-optical coherence tomography was used for choroidal thickness (CT) with frame enhancement software. The study was divided into three groups: Group 1 – singleton pregnancy, Group 2 – twin pregnancy, and Group 3 – healthy nonpregnant controls. CT was measured from nasal, subfoveal, and temporal fields. RESULTS: Regarding CT, the twin pregnancy group had the thickest choroid followed by the singleton pregnancy group and control group. There was a statistically significant difference between Group 2 and Group 3 in terms of nasal, subfoveal, and temporal CTs (P = 0.002, P = 0.001, and P = 0.003, respectively). There was a statistically significant difference between Group 1 and Group 3 regarding just subfoveal CT (P = 0.028). Regarding retinal thickness, there was a statistically significant difference between Group 1 and Group 3 regarding the mean macular volume and ganglion cell-inner plexiform layer thicknesses (P < 0.05). Furthermore, regarding mean retinal nerve fiber layer thickness, there was a statistically significant difference between Group 1 and Group 2 and between Group 2 and Group 3 (P = 0.004, P = 0.003, respectively). CONCLUSION: Our study is the first one which evaluates choroidal and retinal thicknesses in twin pregnancies. We found that there was an increase in CT in the 3rd trimester of pregnancies and it was prominent in twin pregnancies.
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Affiliation(s)
- Sait Alim
- Department of Ophthalmology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Asker Zeki Ozsoy
- Department of Gynecology and Obstetrics, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
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Evaluation of the optic nerve using strain and shear-wave elastography in pre-eclampsia. Clin Radiol 2019; 74:813.e1-813.e9. [DOI: 10.1016/j.crad.2019.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/11/2019] [Indexed: 01/09/2023]
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Ciloglu E, Okcu NT, Dogan NÇ. Optical coherence tomography angiography findings in preeclampsia. Eye (Lond) 2019; 33:1946-1951. [PMID: 31316159 DOI: 10.1038/s41433-019-0531-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/03/2019] [Accepted: 07/01/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To investigate vascular density analysis in the superficial (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ), peripapillary vascular density analysis (PPCVD), and peripapillary retinal nerve fiber thickness analysis (PPRNFL) using optical coherence tomography angiography (OCTA) in pregnant women with preeclampsia and to compare the obtained values with healthy pregnant and nonpregnant healthy individuals. METHODS A total of 98 pregnant women (55 had preeclampsia, 43 were healthy pregnant women) and 38 healthy nonpregnant women of reproductive age were included in the study. The patients were divided into three groups. Group 1 consisted of pregnant women with preeclampsia, group 2 comprised healthy pregnant women without preeclampsia, and group 3 consisted of healthy women who were not pregnant. All participants underwent a comprehensive ophthalmologic examination including OCTA. RESULTS Superficial foveal density (SFD) and deep foveal density (DFD) were lower in group 1 than in group 3 (p = 0.033, p = 0.041, respectively). Deep parafoveal density (DPD), deep temporal density (DTD), and deep superior density (DSD) values were lower in group 1 than in group 2 and group 3 (p = 0.001). PPRNFL superior and mean values were higher in group 1 and group 2 than in group 3 (p = 0.022, p = 0.029, respectively). The mean superior and inferior RPCVD values were significantly higher in group 1 than in group 2 and group 3 (p = 0.001, p = 0.043, and p = 0.001, respectively). CONCLUSIONS In preeclampsia, OCTA shows changes in the microvascular structure of the retina, even without retinopathy findings on biomicroscopy examination.
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Affiliation(s)
- Emine Ciloglu
- Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey.
| | - Nefise Tanrıdan Okcu
- Department of Obstetrics and Gynaecology, Adana City Training and Research Hospital, Adana, Turkey
| | - Neşe Çetin Dogan
- Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey
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Urfalıoglu S, Bakacak M, Özdemir G, Güler M, Beyoglu A, Arslan G. Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography. Pregnancy Hypertens 2019; 17:203-208. [DOI: 10.1016/j.preghy.2019.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 06/24/2019] [Accepted: 07/03/2019] [Indexed: 12/31/2022]
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Jiang MS, Xu XL, Yang T, Li F, Zhang XD. Comparison of Choroidal Thickness in Preeclamptic, Healthy Pregnant, and Nonpregnant Women: A Systematic Review and Meta-Analysis. Ophthalmic Res 2019; 62:1-10. [DOI: 10.1159/000499916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/26/2019] [Indexed: 11/19/2022]
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Evcimen Y, Onur IU, Cengiz H, Yigit FU. Optical Coherence Tomography Findings in Pre-Eclampsia: A Preliminary Receiver Operating Characteristic Analysis on Choroidal Thickness for Disease Severity. Curr Eye Res 2019; 44:916-920. [DOI: 10.1080/02713683.2019.1600198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Yusuf Evcimen
- Department of Ophthalmology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ismail Umut Onur
- Department of Ophthalmology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Huseyin Cengiz
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Fadime Ulviye Yigit
- Department of Ophthalmology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Benfica CZ, Zanella T, Farias LB, Oppermann MLR, Canani LHS, Lavinsky D. Choroidal thickness in preeclampsia measured by spectral-domain optical coherence tomography. Int Ophthalmol 2018; 39:2069-2076. [DOI: 10.1007/s10792-018-1043-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 11/10/2018] [Indexed: 01/12/2023]
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Benfica CZ, Zanella T, Farias LB, Oppermann MLR, Canani LHS, Lavinsky D. Comparative analysis of choroidal thickness in third trimester pregnant women. Int J Retina Vitreous 2018; 4:6. [PMID: 29423278 PMCID: PMC5787921 DOI: 10.1186/s40942-018-0108-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/09/2018] [Indexed: 02/04/2023] Open
Abstract
Background The impact of pregnancy on the choroid is still under investigation. The aim of this study is to compare choroidal thickness measurements of healthy pregnant women in the third trimester and healthy non-pregnant women using spectral-domain optical coherence tomography (OCT). Methods This cross-sectional study included 122 eyes of 61 women, divided into two groups: 27 healthy pregnant women in the third trimester and 34 age-matched healthy non-pregnant women. Choroidal thickness was measured using Enhanced Depth Imaging OCT at ten different locations: at the fovea and every 500 µm from the fovea up to 2500 µm temporally and up to 2000 µm nasally. Results There were no significant differences in the ten measurements of choroidal thickness comparing both groups. Mean subfoveal choroidal thickness was 304.1 + 9.6 µm in the control group and 318.1 + 15.6 µm in the pregnant women group (p = 0.446). There was also no statistically significant association between gestational age and choroidal thickness measurements in the healthy pregnant women group. Conclusions Our study showed no statistically difference in choroidal thickness between healthy non-pregnant women and healthy pregnant women in the third trimester.
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Affiliation(s)
- Camila Zanella Benfica
- 1Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,2Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Teresinha Zanella
- 3Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas Brandolt Farias
- 1Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,2Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Maria Lúcia Rocha Oppermann
- 1Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,3Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luis Henrique Santos Canani
- 1Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,4Department of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Lavinsky
- 1Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,2Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Marcos-Figueiredo P, Marcos-Figueiredo A, Menéres P, Braga J. Ocular Changes During Pregnancy. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2018; 40:32-42. [PMID: 28783856 PMCID: PMC10416176 DOI: 10.1055/s-0037-1605366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022] Open
Abstract
Pregnancy is needed for the perpetuation of the human species, and it leads to physiological adaptations of the various maternal organs and systems. The eye, although a closed space, also undergoes some modifications, most of which are relatively innocuous, but they may occasionally become pathological. For women, pregnancy is a susceptibility period; however, for many obstetricians, their knowledge of the ocular changes that occur during pregnancy tends to be limited. For this reason, this is a important area of study as is necessary the development of guidelines to approach those changes. Of equal importance are the knowledge of the possible therapies for ophthalmological problems in this period and the evaluation of the mode of delivery in particular conditions. For this article, an extensive review of the literature was performed, and a summary of the findings is presented.
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Affiliation(s)
| | | | - Pedro Menéres
- Centro Hospitalar do Porto (CHP), Porto, Portugal
- Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto (ICBAS-UP), Porto, Portugal
| | - Jorge Braga
- Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto (ICBAS-UP), Porto, Portugal
- Centro Materno-Infantil do Norte (CMIN), CHP, Porto, Portugal
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Choroidal Thickness in Women with Uncomplicated Pregnancy: Literature Review. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5694235. [PMID: 29250544 PMCID: PMC5700513 DOI: 10.1155/2017/5694235] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/09/2017] [Indexed: 11/24/2022]
Abstract
Pregnancy is a time when many changes occur in a woman's body. The goal of these changes is the provision of optimum conditions for the development of the foetus. Pregnancy also affects eye physiology. Well recognized physiological changes include a reduced corneal sensitivity, an increase in its central thickness and curvature, and a decrease in intraocular pressure. The association between choroidal thickness and pregnancy is not clear. Haemodynamic and hormonal changes taking place during pregnancy and the question of whether these changes are reflected by choroidal thickness are especially important. It is assumed that the choroid, which is one of the most highly vascularized tissues characterized by the highest blood flow to tissue volume ratio in the whole body, should respond by an increase in its thickness to an increase in blood flow and drop in the value of peripheral resistance. Measurement of choroidal thickness using enhanced depth imaging optical coherence tomography (EDI-OCT) in women with uncomplicated pregnancy provides important information concerning the effects of physiological changes in the eye.
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Takahashi J, Kado M, Mizumoto K, Igarashi S, Kojo T. Changes in Subfoveal Choroidal Thickness During Pregnancy and After Delivery. Ophthalmic Surg Lasers Imaging Retina 2017; 48:816-821. [PMID: 29020425 DOI: 10.3928/23258160-20170928-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 05/30/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE This study was performed to investigate longitudinal changes in the subfoveal choroidal thickness (SFCT) during pregnancy and after delivery. PATIENTS AND METHODS The SFCT was measured in the first and third trimesters, shortly after delivery, and 1 month after delivery in 25 eyes of 25 women. Enhanced depth imaging optical coherence tomography was used for measurement. RESULTS The mean SFCT was 347 μm ± 86 μm, 329 μm ± 81 μm, 333 μm ± 81 μm, and 330 μm ± 87 μm in the first and third trimesters, shortly after delivery, and 1 month after delivery, respectively. The SFCT in the first trimester was significantly greater than that in the third trimester, shortly after delivery, and 1 month after delivery. CONCLUSIONS This study indicates that the SFCT is greater in the first trimester and decreases in the third trimester of pregnancy. The SFCT does not subsequently change until 1 month after delivery. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:816-821.].
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Arab M, Entezari M, Ghamary H, Ramezani A, Ashori A, Mowlazadeh A, Yaseri M. Peripapillary retinal nerve fiber layer thickness in preeclampsia and eclampsia. Int Ophthalmol 2017; 38:2289-2294. [DOI: 10.1007/s10792-017-0718-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 09/18/2017] [Indexed: 11/28/2022]
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Zhang J, Wang H, Yu Q, Tong Q, Lu Q. Enhanced Depth Imaging Optical Coherence Tomography: A New Way Measuring Choroidal Thickness in Pregnant Women. J Ophthalmol 2017; 2017:8296574. [PMID: 28630765 PMCID: PMC5463124 DOI: 10.1155/2017/8296574] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/18/2017] [Indexed: 12/28/2022] Open
Abstract
The body changes markedly during pregnancy; each system behaves differently from a nonpregnant state. As the eyes are the only windows to see directly what is going on in the internal environment, more and more researches have been done to explain the association between ocular changes and the physiological and pathological changes during pregnancy. The choroid is one of the critical parts of the eye, providing nutrition. And abnormal choroid may result in ocular dysfunction and visual problems. As the optical coherence tomography develops, a rapid, direct, noninvasive, and nontoxic way is available to obtain the choroid situation of pregnant women, which may explain the mechanism of pregnancy-related eye diseases. This review would summarize relevant original articles published from January 1, 2008 to December 1, 2016 to assess the changes of choroidal thickness (CT) with enhanced depth imaging optical coherence tomography (EDI-OCT) during pregnancy. And the relationship between choroidal thickness changes and pregnancy remains uncertain. To our knowledge, this is the first review of EDI-OCT in assessing the choroidal thickness of the pregnant women.
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Affiliation(s)
- Jun Zhang
- Medical School of Ningbo University, 818 Fenghua Road, Ningbo, Zhejiang, China
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Huiyun Wang
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Qiubo Yu
- Department of Obstetrics, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Qihu Tong
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
| | - Qinkang Lu
- Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, 251 Baizhang East Road, Ningbo, Zhejiang, China
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Tan KA, Gupta P, Agarwal A, Chhablani J, Cheng CY, Keane PA, Agrawal R. State of science: Choroidal thickness and systemic health. Surv Ophthalmol 2016; 61:566-81. [DOI: 10.1016/j.survophthal.2016.02.007] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 02/28/2016] [Accepted: 02/29/2016] [Indexed: 12/12/2022]
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Liu R, Kuang GP, Luo DX, Lu XH. Choroidal thickness in pregnant women: a cross-sectional study. Int J Ophthalmol 2016; 9:1200-6. [PMID: 27588276 DOI: 10.18240/ijo.2016.08.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/21/2016] [Indexed: 01/18/2023] Open
Abstract
AIM To investigate choroidal thickness in pregnant women and compare the measurements with those of normal nonpregnant women. METHODS Using enhanced depth imaging optical coherence tomography (EDI-OCT), choroidal thickness was measured at the fovea and at 1 mm and 3 mm superior, inferior, temporal, and nasal to the fovea in both healthy pregnant women and nonpregnant women. Pearson correlation analysis was performed to evaluate the relationships between subfoveal choroidal thickness (SFCT) and the demographic and ocular parameters. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed-effects model when Meta-analyses were conducted. RESULTS Comparison of choroidal thickness between the groups showed that it was significantly greater in healthy pregnant women's eyes than in normal nonpregnant women's eyes at all locations except at 3 mm superior and 3 mm temporal from the fovea (P<0.05). The mean SFCT was 344.13±50.94 µm in healthy pregnant women's eyes and 315.03±60.57 µm in normal nonpregnant women's eyes, with a statistically significant difference (P=0.008). Pearson correlation analysis showed that age and axial length were significantly related to SFCT in healthy pregnant women, normal nonpregnant women, and all subjects. The results of our cross-sectional study were consistent with the results of the further Meta-analysis, with a pooled weighted mean difference (WMD) of 33.66 µm (95% CI: 26.16 to 41.15) for SFCT. CONCLUSION Our results, along with the comprehensive Meta-analysis, suggest that choroidal thickness in healthy pregnant women is greater than that in normal nonpregnant women.
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Affiliation(s)
- Ru Liu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China; Department of Ophthalmology, the First People's Hospital of Chenzhou, Chenzhou 423001, Hunan Province, China
| | - Guo-Ping Kuang
- Department of Ophthalmology, the First People's Hospital of Chenzhou, Chenzhou 423001, Hunan Province, China
| | - Di-Xian Luo
- Institute of Translational Medicine, the First People's Hospital of Chenzhou, Chenzhou 423001, Hunan Province, China
| | - Xiao-He Lu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China
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