Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA.
Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA.
J Ultrasound Med. 2023 Dec;42(12):2815-2824. doi: 10.1002/jum.16320. Epub 2023 Aug 22.
Preeclampsia (PE) is a severe complication of pregnancy characterized by hypertension, proteinuria and compromised fetal blood supply. The eye, like other end organs, is affected by this systemic condition, but unlike in other organs, ocular media transparency allows high-resolution optical visualization of the vascular structure of the retina. Our aim was to assess how ultrasound-determined ocular blood-flow correlates with vascular structure of the retina and choriocapillaris determined by optical coherence tomography angiography (OCTA).
Plane-wave ultrasound and OCTA were performed on both eyes of 40 consecutive subjects consisting of normal controls (n = 11), mild PE (n = 5), severe PE (n = 17) and chronic or gestational hypertension (n = 7) within 72 hours following delivery. From ultrasound, we measured pulsatile flow velocity and resistance indices in the central retinal artery (CRA) and vein, the short posterior ciliary arteries (SPCAs) and choroid. From OCTA, we measured vascular density (VD) in the superficial, deep retina and choriocapillaris. We determined differences in Doppler and OCTA parameters among groups and correlations between ultrasound and OCTA.
In severe PE, flow resistance was reduced with respect to controls. Flow velocity and resistance in the and SPCA were moderately correlated with VD in the choriocapillaris and peripapillary retina, but VD in PE did not differ significantly from controls.
Although OCTA parameters were moderately correlated with Doppler ultrasound, OCTA did not demonstrate significant differences between PE and controls postpartum.
子痫前期(PE)是一种严重的妊娠并发症,其特征是高血压、蛋白尿和胎儿血液供应受损。眼睛与其他终末器官一样受到这种全身状况的影响,但与其他器官不同的是,眼部介质的透明度允许对视网膜的血管结构进行高分辨率的光学可视化。我们的目的是评估超声确定的眼血流与光相干断层扫描血管造影(OCTA)确定的视网膜和脉络膜毛细血管的血管结构如何相关。
对 40 例连续受试者的双眼进行平面波超声和 OCTA 检查,包括正常对照组(n=11)、轻度 PE(n=5)、重度 PE(n=17)和慢性或妊娠期高血压(n=7)。这些受试者均在分娩后 72 小时内接受检查。从超声中,我们测量了中央视网膜动脉(CRA)和静脉、短后睫状动脉(SPCA)和脉络膜的搏动血流速度和阻力指数。从 OCTA 中,我们测量了浅层、深层视网膜和脉络膜毛细血管的血管密度(VD)。我们确定了各组之间多普勒和 OCTA 参数的差异,以及超声和 OCTA 之间的相关性。
在重度 PE 中,与对照组相比,血流阻力降低。CRA 和 SPCA 的血流速度和阻力与脉络膜毛细血管和视盘周围视网膜的 VD 中度相关,但 PE 中的 VD 与对照组相比无显著差异。
尽管 OCTA 参数与多普勒超声有中度相关性,但产后 PE 与对照组之间的 OCTA 无显著差异。