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Okuyan E, Akgül O, Baysal Z, Mangan MS, Bayramoglu D, Tureyici L. The Effect of Hyperemesis Gravidarum on Macular Thickness, Corneal Thickness, and Intraocular Pressure in Pregnancy. Z Geburtshilfe Neonatol 2024; 228:240-245. [PMID: 38698625 DOI: 10.1055/a-2299-3345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
AIM Physiological changes in intraocular pressure as well as in the cornea and macula may occur during pregnancy. Therefore, we decided to investigate the effect of hyperemesis gravidarum on macular thickness, corneal thickness and intraocular pressure (IOP). MATERIAL AND METHODS A total of 110 people, 55 of whom were diagnosed with hyperemesis gravidarum and 55 of whom were in the control group, were included in the study. The inclusion criteria for the study were as follows: first trimester (8-14 weeks of gestation) pregnancy with positive fetal heartbeat and no history of systemic disease, no continuous use of medication, diagnosis of hyperemesis gravidarum (ketonuria and weight loss of more than 3 kilograms or 5% of body weight), body mass index (BMI) within normal limits, age between 18 and 40, no alcohol use or smoking. RESULTS In the HG group compared to the control group, there was a difference between the CCT values of both the right and left eyes (p<0.01). There was a difference in both right and left IOP values in patients in the HG group compared to the control group (p<0.05), and there was no correlation between ketonuria scores and right and left eye CCT values, right and left eye macular thickness, and right and left eye pressure in patients diagnosed with HG (p>0.05). CONCLUSION In hyperemesis gravidarum, changes occur in IOP, corneal thickness, and macular thickness. In ophthalmic examinations in the pregestational period, especially for women with systemic disease, it may be important for clinicians to take the necessary precautions in this regard.
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Affiliation(s)
- Erhan Okuyan
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
| | - Ozlem Akgül
- Department of Obstetrics and Gynecology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Zeki Baysal
- Department of Ophthalmology, Batman Training and Research Hospital, Batman, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, University of Health Science, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
| | - Denizhan Bayramoglu
- Department of Obstetrics and Gynecology, Mardin Training and Research Hospital, Mardin, Turkey
| | - Lena Tureyici
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
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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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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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Morya AK, Gogia S, Gupta A, Prakash S, Solanki K, Naidu AD. Motherhood: What every ophthalmologist needs to know. Indian J Ophthalmol 2021; 68:1526-1532. [PMID: 32709768 PMCID: PMC7640830 DOI: 10.4103/ijo.ijo_2033_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this review article is to summarize the available literature on physiologic and pathologic ocular changes during pregnancy and the effect of diseases in pregnancy. A literature search was conducted using PUBMED, MEDLINE, and Cochrane library in English. In addition, the cited references in the published articles were manually reviewed for the relevant results. Pregnancy encompasses a multitude of changes in all body systems, including the visual system of the female. The changes can be physiological, i.e., changes occurring in the lids and adnexa, cornea, conjunctiva, changes in tear film composition and intraocular pressure, retina, choroid, and visual field. Pathological changes in a pregnant woman's eye include changes related to preeclampsia and eclampsia, central serous chorioretinopathy, retinal artery or vein occlusions, and disseminated intravascular coagulation. Preexisting diseases like diabetic retinopathy, Graves' disease, idiopathic intracranial hypertension, various inflammatory conditions can undergo changes in their course during pregnancy. Ophthalmic medications can have an effect on both mother and the baby and hence should be used cautiously. In addition, intrauterine infections play a major role in causing inflammation in the eye of the baby. Hence, vaccination of the mother prior to pregnancy plays an important role in preventing intrauterine infections in the neonate. A regular eye examination in the perinatal period plays a vital role in recognizing ophthalmic pathologies which might require a prompt medical intervention. Pathological ocular diseases should be discriminated from physiologic changes to establish an individualized treatment or preventive plan. This approach to ocular benefits of treatment to the mother should always weigh against the potential harm to the fetus.
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Affiliation(s)
- Arvind K Morya
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Sonalika Gogia
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Arushi Gupta
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Sujeet Prakash
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
| | - Kanchan Solanki
- Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India
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Shalaby HS, ElSebaay ME, Samy MM. Comparison Between Central Choroidal Thickness in Pregnant Diabetic Females and Pregnant Non-Diabetic Females. Clin Ophthalmol 2021; 15:105-111. [PMID: 33469256 PMCID: PMC7811481 DOI: 10.2147/opth.s289514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/31/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To compare choroidal thickness in pregnant women with and without diabetes mellitus (DM). Methods Sixty pregnant females (60 eyes) were enrolled in this cross-sectional controlled study. They were divided into two groups: Group A (30 patients; 30 eyes) were pregestational diabetic pregnant females, while Group B (30 patients; 30 eyes) were non-diabetic pregnant females. Exclusion criteria were high-risk pregnancy, diabetic retinopathy in Group A subjects, systemic or ophthalmological pathology, drug intake other than vitamin supplements and diabetic medications, and large errors of refraction. All patients underwent full ophthalmological examination and enhanced depth imaging optical coherence tomography (EDI-OCT) to measure the choroidal thickness in the nine zones of the Early Treatment Diabetic Retinopathy Study (ETDRS) map. Results Our results show that Group A eyes (of pregnant diabetic females) had a highly significant greater choroidal thickness than Group B eyes (of pregnant non-diabetic females) in all nine zones of the ETDRS map (p-value <0.01). Moreover, we found a positive linear correlation between the duration of DM and the degree of choroidal thickening. Conclusion Pregnant diabetic females have a thicker choroid than that of pregnant non-diabetic females.
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Affiliation(s)
- Hisham Samy Shalaby
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Mohamed Mahmoud Samy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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6
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Pomytkina NV, Sorokin EL. [Morphometric study of the choroid in pregnant women with disorders of carbohydrate metabolism]. Vestn Oftalmol 2020; 136:165-170. [PMID: 33371645 DOI: 10.17116/oftalma2020136062165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In recent years, much attention is being paid to studying the state of the choroid in various eye pathologies, but changes in the choroid of pregnant women with disorders of glucose metabolism remain unexplored. PURPOSE To study choroidal thickness in pregnant women with disorders of carbohydrate metabolism in the III trimester. MATERIAL AND METHODS The study included 376 pregnant women in the third trimester of pregnancy: 49 of them had type 1 diabetes (T1D), 248 had gestational diabetes (GD), and 79 were healthy pregnant women who comprised the control group. Three subgroups were distinguished among patients with GD, depending on the timing of the development of GD in the I (160 patients), II (56 patients), or III (32 patients) trimesters. Optical coherence tomography was performed to measure choroidal thickness in the foveal region. RESULTS In patients with GD, no significant differences in average indexes of choroidal thickness in subgroups with different timing of diabetes development were observed, however, the pregnant women of the GD subgroup with beginning of its development in the first trimester had the smallest indexes of average choroidal thickness. In pregnant women with GD who received insulin, choroidal thickness was lower than in patients who did not receive it, although statistical significance of that was not established. In patients with T1D and diabetic retinopathy (DR), choroidal thickness was significantly lower compared to patients with T1D without DR, GD and control groups. Obtained data indicates the presence of changes in the choroid and development of diabetic choroidopathy in pregnant women with T1D and DR. CONCLUSION The study of choroidal changes in pregnant women with disorders of carbohydrate metabolism can help identify criteria for manifestation of diabetic microangiopathy, choroidopathy, and predict the progression of DR.
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Affiliation(s)
- N V Pomytkina
- Khabarovsk branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Khabarovsk, Russia
| | - E L Sorokin
- Khabarovsk branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Khabarovsk, Russia.,Far-Eastern State Medical University, Khabarovsk, Russia
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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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Casini G, Marinò M, Rubino M, Licari S, Covello G, Mazzi B, Ionni I, Rocchi R, Sframeli AT, Figus M, Loiudice P. Retinal, choroidal and optic disc analysis in patients with Graves' disease with or without orbitopathy. Int Ophthalmol 2020; 40:2129-2137. [PMID: 32358735 DOI: 10.1007/s10792-020-01392-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare optic disc, retinal and choroidal measurements in patients with Graves' disease with or without orbitopathy, and healthy controls. METHODS Optical coherence tomography and Heidelberg retinal tomography were performed in 40 patients with Graves' orbitopathy (GO), 40 subjects with Graves's disease (GD) with no sign of orbitopathy and 40 healthy controls. Degree of exophthalmos, ocular alignment, clinical activity score (CAS), choroidal thickness, retinal thickness, ganglion cell layer (GCL) thickness, disc area, cup area, rim area, cup/disc area ratio, linear cup/disc ratio and mean peripapillary retinal nerve fibre layer thickness were analysed. RESULTS GO patients and healthy controls significantly differ regarding mean central retinal thickness (275 ± 19 µm and 285 ± 20 µm, P = 0.017); mean central GCL thickness (14.87 ± 3.0 µm and 17.92 ± 5.02 µm, P = 0.001); mean disc area (2.00 ± 0.44 mm2 and 1.72 ± 0.37 mm2, P = 0.003); mean cup area (0.53 ± 0.52 mm2 and 0.31 ± 0.20 mm2, P = 0.003); cup/disc area ratio (0.22 ± 0.10 and 0.17 ± 0.08, P = 0.010); and linear cup/disc ratio (0.47 ± 0.15 and 0.40 ± 0.13, respectively, P = 0.011). No difference was found between patients without orbitopathy and healthy controls. No significant difference was found regarding the choroidal thickness between the three groups. There was no statistically significant relationship between retinal thickness, ganglion cell layer thickness, mean disc area, mean cup area, cup/disc area ratio, linear cup/disc ratio, CAS, exophthalmometric value and ocular alignment. CONCLUSION GO patients showed significant changes in foveal and GCL thickness, and optic nerve head morphology suggesting a possible influence of the orbital inflammatory process.
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Affiliation(s)
- Giamberto Casini
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Michele Marinò
- Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Marisa Rubino
- Azienda Socio-Sanitaria Territoriale Di Mantova, Mantova, Italy
| | - Serena Licari
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Giuseppe Covello
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Barbara Mazzi
- Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Ilaria Ionni
- Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Roberto Rocchi
- Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Angela Tindara Sframeli
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Michele Figus
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Pasquale Loiudice
- Ophthalmology Unit, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
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Relationship between Size of the Foveal Avascular Zone and Carbohydrate Metabolic Disorders during Pregnancy. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3261279. [PMID: 31781611 PMCID: PMC6874923 DOI: 10.1155/2019/3261279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 11/18/2022]
Abstract
Aim To determine whether the area of the foveal avascular zone (FAZ), as a morphological indicator of the microcirculation of the perifoveal capillary network, changes in the carbohydrate metabolism disorders during pregnancy (the gestational age of patients with gestational diabetes mellitus (GDM) and preexisting diabetes (PexD)). Methods Ten normal individuals and 41 eyes of 41 patients, 28 with GDM and 13 with PexD, were studied. A 3 × 3 mm area of the FAZ of the superficial capillary plexus layer (SCP) and the deep capillary plexus layer (DCP) was determined by optical coherence tomography angiography (OCTA; RS-3000 Advance, NIDEK). The significance of the correlation between the size of the FAZ and the weeks of pregnancy was determined. Results The area of the FAZ of the SCP was 0.38 ± 0.11 mm2 (normal eyes), 0.41 ± 0.16 mm2 (GDM), and 0.43 ± 0.10 mm2 (PexD). The area of the FAZ of the DCP was 0.78 ± 0.23 mm2 (normal eyes), 0.69 ± 0.16 mm2 (GDM), and 0.79 ± 0.25 mm2 (PexD). No significant difference in the FAZ sizes was observed between the groups. The average number of weeks of pregnancy was 24.1 ± 8.2 weeks in the eyes with GDM and 23.3 ± 11.4 weeks in the eyes with PexD (P > 0.05). Significant correlations were found between the size of the FAZ of the SCP and the number of weeks (r = 0.37, P=0.04 for GDM, and r = 0.49, P=0.04 for PexD, Spearman's rank-order correlation coefficient). Conclusions For GDM and PexD under established glycemic control, the area of the FAZ is not affected, but vascular changes occurred at the early phase of pregnancy.
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Benfica CZ, Zanella T, Farias LB, Oppermann MLR, Canani LHS, Lavinsky D. Macular choroidal thickness in pregnant women with type 1, type 2 and gestational diabetes mellitus measured by spectral-domain optical coherence tomography. Clin Ophthalmol 2018; 12:1259-1265. [PMID: 30050277 PMCID: PMC6055625 DOI: 10.2147/opth.s166620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Purpose To analyze choroidal thickness (CT) of pregnant women with type 1 diabetes mellitus (DM), type 2 DM and gestational diabetes mellitus (GDM) using spectral-domain optical coherence tomography. Patients and methods This cross-sectional study included 144 eyes of 72 pregnant women in the third trimester divided into four groups: 27 non-diabetic pregnant women; 15 pregnant women with GDM; 16 with type 2 DM and 14 with type 1 DM. CT was measured using optical coherence tomography at ten different locations. We also analyzed possible confounding factors, such as gestational age, glycosylated hemoglobin, time from DM diagnosis, hypertension and severity of diabetic retinopathy. Results The comparison between the four groups showed a thinner choroid in patients with type 1 DM in all locations, with statistical significance in subfoveal and temporal measurements. When comparing only patients with type 1 and type 2 DM, adjusting for confounding factors, the choroid of patients with type 1 DM remained thinner at all macular points, also with statistical significance in subfoveal and temporal measurements. Conclusion Pregnant women with type 1 DM had significantly thinner CT measurements on subfoveal and temporal locations. No differences were found in CT between the control group and pregnant women with GDM and type 2 DM.
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Affiliation(s)
- Camila Zanella Benfica
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,
| | - Teresinha Zanella
- Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas Brandolt Farias
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,
| | - Maria Lúcia Rocha Oppermann
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luis Henrique Santos Canani
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil,
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Kocamış Ö, Zorlu D. Choroid and Retinal Nerve Fiber Layer Thickness in Patients with Chronic Obstructive Pulmonary Disease Exacerbation. J Ophthalmol 2018; 2018:1201976. [PMID: 30116623 PMCID: PMC6079521 DOI: 10.1155/2018/1201976] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/09/2018] [Accepted: 06/13/2018] [Indexed: 12/19/2022] Open
Abstract
PURPOSE We aimed at measuring the choroid and retinal nerve fiber layer thickness with optic coherence tomography (OCT) in patients diagnosed with chronic obstructive pulmonary disease (COPD). METHODS A total of 60 patients with COPD and 23 healthy controls were evaluated in the scope of this prospective, observational study. COPD patients were divided into two groups as those that were stable and those with an exacerbation based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. Subfoveal choroid thickness (SFCT) of the patients and the control group was compared by measuring the choroid thickness at points 1000 µm nasal and temporal to the fovea and the mean retinal nerve fiber layer (RNFL) thickness. RESULTS The subfoveal choroid thickness of the COPD patients in both the exacerbation and stable groups was found to be statistically significantly thinner than the control group (p=0.047 and p=0.046, resp.). No statistically significant difference was found between the subfoveal choroid thickness of the patients that were stable and those that had an exacerbation (p=0.813). No statistically significant difference was found between the mean RNFL, 1000 µm nasal, or 1000 µm temporal choroid thicknesses of the COPD patients and the control group (p=0.263, p=0.455, and p=0.611, resp.). CONCLUSION Decreased subfoveal choroid thickness was found in the COPD patients both during an exacerbation and in the stable period, when compared to the control group. The mean RNFL thickness was similar in the exacerbation and stable period of the stable COPD patients when compared to the control group. This suggests that ocular findings might be important in terms of COPD morbidity. This trial is registered with www.chictr.org.cn/enIndex.aspx.
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Affiliation(s)
- Özkan Kocamış
- Department of Ophthalmology, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
| | - Duygu Zorlu
- Department of Pulmonary Medicine, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
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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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14
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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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15
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Can ME, Kaplan FE, Uzel MM, Kiziltoprak H, Ergun MC, Koc M, Simsek G. The association of Helicobacter pylori with choroidal and retinal nerve fiber layer thickness. Int Ophthalmol 2017; 38:1915-1922. [PMID: 28780617 DOI: 10.1007/s10792-017-0677-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the effect of Helicobacter pylori (H. pylori) infection on choroidal thickness (CT) and retinal nerve fiber layer thickness (RNFLT). METHODS The study included 25 patients with H. pylori infection and 25 healthy individuals as the control group. Helicobacter pylori patients were classified as the pre-treatment (Group 1; n: 25) and the post-treatment (Group 2; n: 25). RNFLT and CT were measured before and after treatment of H. pylori infection, using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The axial length and intraocular pressure were also measured. RESULTS The mean subfoveal CT was 320.96 ± 29.15 μm in Group 1 and 287.48 ± 49.17 in the control group (p = 0.007), while the mean subfoveal CT did not show any difference between Group 2 and the control group (p > 0.05). No statistically significant difference was determined between the H. pylori patients and the control group in respect of RNFLT values (p > 0.05). CONCLUSIONS CT increases during H. pylori infection and returns to the normal range within 6 weeks of treatment. RNFLT does not show any change during H. pylori infection. The data related to the subfoveal CT may be useful in understanding the pathogenesis of central serous chorioretinopathy developing in H. pylori patients.
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Affiliation(s)
- Mehmet Erol Can
- Department of Ophthalmology, Kecioren Training and Research Hospital, Yasamkent Mah. 3208 Sk. Gulbeng Sitesi No: 1-49, Cankaya, Ankara, Turkey.
| | - Fatma Efe Kaplan
- Department of Internal Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | | | - Hasan Kiziltoprak
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Cagri Ergun
- Department of Internal Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Gülcin Simsek
- Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey
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16
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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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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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