Stern-Ascher Conrad N, North Victoria S, Garg Aakriti, Ananth Cande V, Wapner Ronald J, Bearelly Srilaxmi
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.
Am J Perinatol. 2021 Apr;38(5):482-489. doi: 10.1055/s-0039-1698832. Epub 2019 Nov 4.
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.
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.
Cases showed no difference in subfoveal choroidal thickness compared with controls ( = 0.65). Amongst cases, subfoveal choroidal thickness and gestational age at delivery were inversely related ( = 0.86, < .001). There was a positive association of placental growth factor with subfoveal choroidal thickness amongst cases ( = 0.54, = 0.002).
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.
重度子痫前期约占所有妊娠的1%。重度子痫前期的一个典型特征是新发视力障碍。脉络膜易于进行高分辨率、非侵入性成像,这使其成为子痫前期疾病预测、分层或监测研究的合理目标。本研究旨在比较重度子痫前期患者与血压正常孕妇的黄斑中心凹下脉络膜厚度,并研究这些结果与疾病严重程度的其他指标(包括孕周和血清血管生成因子)之间的关联。
我们设计了一项病例对照研究,纳入36例诊断为重度子痫前期的女性(病例组),根据种族/族裔和产次与同样在产后诊断的37例血压正常女性(对照组)进行匹配。所有患者均接受了增强深度成像光谱域光学相干断层扫描和血清分析。
病例组与对照组相比,黄斑中心凹下脉络膜厚度无差异(=0.65)。在病例组中,黄斑中心凹下脉络膜厚度与分娩时的孕周呈负相关(=0.86,<0.001)。病例组中胎盘生长因子与黄斑中心凹下脉络膜厚度呈正相关(=0.54,=0.002)。
本研究提示疾病严重程度与脉络膜增厚程度之间存在关联。我们还显示该指标与产后胎盘生长因子水平之间存在关联。