Ali S, Mukasa D C, Lukakamwa D, Nakayenga A, Namagero P, Biira J, Byamugisha J, Papageorghiou A T
Department of Obstetrics and Gynecology, Makerere University Hospital, Makerere University, Kampala, Uganda.
Julius Global Health, Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Ultrasound Obstet Gynecol. 2025 Feb;65(2):163-172. doi: 10.1002/uog.29162. Epub 2025 Jan 20.
To examine the relationship of ophthalmic artery (OA) Doppler indices with uterine artery (UtA) Doppler indices, selected maternal hemodynamic parameters and gestational age, and to evaluate the intraobserver reproducibility of OA Doppler indices.
This was a prospective cohort study of women recruited between 11 + 0 and 23 + 6 weeks' gestation using a stratified and random sampling approach to ensure adequate distribution across the gestational-age range. OA pulsatility index (PI), first peak systolic velocity (PSV1), second peak systolic velocity (PSV2) and peak systolic velocity ratio (PSV ratio), calculated as PSV2/PSV1, were measured twice in each eye by the same observer. UtA-PI was also measured twice on each side by the same observer. Maternal hemodynamic assessment was undertaken using an ultrasonic cardiac output monitor (USCOM 1A). Pearson's and Spearman's rank correlation coefficients were used to assess the correlations between variables, and Bland-Altman plots were used to evaluate the intraobserver reproducibility of OA Doppler indices.
Of 194 women invited to participate in the study, 169 were eligible for inclusion, of whom 16 were excluded following an obstetric ultrasound scan and a further three owing to inadequate or incomplete OA or UtA Doppler assessment, leaving 150 women in the final analysis. Log UtA-PI had a weak correlation with both OA-PI (r = -0.19 (95% CI, -0.34 to -0.03), P = 0.021) and OA-PSV ratio (r = 0.31 (95% CI, 0.15-0.45), P < 0.001). The correlation between gestational age and OA-PI was non-significant (r = 0.14 (95% CI, -0.03 to 0.29), P = 0.097), and that between gestational age and OA-PSV ratio was weak (r = -0.23 (95% CI, -0.38 to -0.07), P = 0.004), as opposed to the strong correlation between gestational age and UtA-PI (r = -0.68 (95% CI, -0.76 to -0.58), P < 0.001). No strong correlations were observed between OA-PI or OA-PSV ratio and maternal hemodynamic indices. The correlations were unaltered by adjustment for maternal age and body mass index. The intraobserver reproducibility of OA-PI and OA-PSV ratio in the same eye was high. The correlation between the right and left eyes was moderate for OA-PI (r = 0.63 (95% CI, 0.53-0.72), P < 0.001) and strong for OA-PSV ratio (r = 0.81 (95% CI, 0.75-0.86), P < 0.001).
OA-PI and OA-PSV ratio had a weak or no correlation with UtA-PI and maternal hemodynamic parameters, meaning that they can be used as independent predictors for pre-eclampsia. Gestational age had no clinically relevant effect on OA-PI and OA-PSV ratio, suggesting that these indices could be measured without adjustment at any time between 11 and 23 weeks' gestation. OA Doppler indices had high intraobserver reproducibility and were strongly correlated between the right and left eyes. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
研究眼动脉（OA）多普勒指数与子宫动脉（UtA）多普勒指数、选定的母体血流动力学参数及孕周之间的关系，并评估OA多普勒指数的观察者内重复性。
这是一项前瞻性队列研究，采用分层随机抽样方法招募妊娠11 + 0至23 + 6周的女性，以确保在孕周范围内分布均匀。由同一观察者对每只眼睛测量两次OA搏动指数（PI）、第一峰收缩期速度（PSV1）、第二峰收缩期速度（PSV2）以及峰收缩期速度比值（PSV比值，计算方法为PSV2/PSV1）。同一观察者也对每侧子宫动脉PI测量两次。使用超声心输出量监测仪（USCOM 1A）进行母体血流动力学评估。采用Pearson和Spearman等级相关系数评估变量之间的相关性，并用Bland-Altman图评估OA多普勒指数的观察者内重复性。
在邀请参与研究的194名女性中，169名符合纳入标准，其中16名在产科超声扫描后被排除，另有3名因OA或UtA多普勒评估不足或不完整被排除，最终分析纳入150名女性。Log UtA-PI与OA-PI（r = -0.19（9�%CI，-0.34至-0.03），P = 0.021）和OA-PSV比值（r = 0.31（9�%CI，0.15 - 0.45），P < 0.001）均呈弱相关。孕周与OA-PI之间的相关性不显著（r = 0.14（9�%CI，-0.03至0.29），P = 0.097），孕周与OA-PSV比值之间呈弱相关（r = -0.23（9�%CI，-0.38至-0.07），P = 0.004），而孕周与UtA-PI之间呈强相关（r = -0.68（9�%CI，-0.76至-0.58），P < 0.001）。未观察到OA-PI或OA-PSV比值与母体血流动力学指标之间存在强相关性。经母体年龄和体重指数校正后，相关性无变化。同一眼内OA-PI和OA-PSV比值的观察者内重复性较高。右眼和左眼之间，OA-PI的相关性为中度（r = 0.63（9�%CI，0.53 - 0.72），P < 0.001），OA-PSV比值的相关性为强相关（r = 0.81（9�%CI，0.75 - 0.86），P < 0.001）。
OA-PI和OA-PSV比值与UtA-PI和母体血流动力学参数呈弱相关或无相关性，这意味着它们可作为子痫前期的独立预测指标。孕周对OA-PI和OA-PSV比值无临床相关影响，提示在妊娠11至23周之间的任何时间均可无需校正地测量这些指数。OA多普勒指数具有较高的观察者内重复性，且右眼和左眼之间相关性强。© 2025作者。《超声妇产科》由John Wiley & Sons Ltd代表国际妇产科超声学会出版。
