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使用频域光学相干断层扫描技术评估妊娠期单纯性和高血压疾病的黄斑下脉络膜厚度及其产后相关性。

Evaluation of Subfoveal Choroidal Thickness in Uncomplicated and Hypertensive Disorders of Pregnancy Using Spectral-Domain Optical Coherence Tomography and Its Postpartum Correlation.

作者信息

Nyodu Richa, Verma Vidhya, Karkhur Samendra, Singh Priti, Gupta Saroj

机构信息

Ophthalmology, Shroff Eye Centre, New Delhi, IND.

Ophthalmology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.

出版信息

Cureus. 2025 Aug 9;17(8):e89709. doi: 10.7759/cureus.89709. eCollection 2025 Aug.

Abstract

Purpose This study aimed to evaluate subfoveal choroidal thickness (SFCT) in women with uncomplicated pregnancy and those with hypertensive disorders of pregnancy (HDP), using spectral-domain optical coherence tomography (SD-OCT), and to assess changes in SFCT during the postpartum period. Methods The study was jointly carried out in the Departments of Ophthalmology and Obstetrics & Gynaecology at All India Institute of Medical Sciences, Bhopal, a tertiary care referral centre in central India, over a period of 18 months, from March 2021 to September 2022. A hospital-based cross-sectional study was conducted on pregnant women in their third trimester, including those with HDP and those with uncomplicated pregnancies. All participants underwent routine antenatal work-up, comprehensive ocular examination, and enhanced depth imaging optical coherence tomography (EDI-OCT) to measure SFCT. Follow-up assessments were performed at six weeks postpartum to evaluate postnatal changes in choroidal thickness. Results A total of 96 eyes from 48 pregnant women were evaluated. An overall increase in SFCT was observed in the postpartum period; however, this increase was not statistically significant, possibly due to the small sample size and loss to follow-up postpartum. In addition, the mean SFCT was higher in the uncomplicated pregnancy group compared to those with HDP, although this difference was also statistically insignificant. Despite limited statistical power, these findings suggest that HDP may influence choroidal thickness differently compared to normotensive pregnancies. Conclusion This study highlights the potential role of SFCT as a non-invasive biomarker for early identification and risk stratification of hypertensive disorders in pregnancy. Although the results did not reach statistical significance, the observed trends support the hypothesis that choroidal vascular changes may reflect underlying systemic vascular dysregulation in HDP. Future research with larger sample sizes and longer follow-up is warranted to validate these findings and to explore the utility of mean-adjusted choroidal thickness as a predictive marker for HDP severity and progression.

摘要

目的 本研究旨在使用谱域光学相干断层扫描(SD-OCT)评估未合并症妊娠妇女和妊娠高血压疾病(HDP)妇女的黄斑中心凹下脉络膜厚度(SFCT),并评估产后期间SFCT的变化。方法 该研究于2021年3月至2022年9月在印度中部的三级医疗转诊中心——博帕尔全印医学科学研究所的眼科和妇产科联合开展,为期18个月。对孕晚期孕妇进行了一项基于医院的横断面研究,包括患有HDP的孕妇和未合并症妊娠的孕妇。所有参与者均接受了常规产前检查、全面的眼部检查以及增强深度成像光学相干断层扫描(EDI-OCT)以测量SFCT。在产后六周进行随访评估,以评估脉络膜厚度的产后变化。结果 共评估了48名孕妇的96只眼。产后期间观察到SFCT总体增加;然而,这种增加在统计学上并不显著,可能是由于样本量小和产后失访所致。此外,未合并症妊娠组的平均SFCT高于患有HDP的组,尽管这种差异在统计学上也不显著。尽管统计效力有限,但这些发现表明,与血压正常的妊娠相比,HDP可能对脉络膜厚度有不同的影响。结论 本研究强调了SFCT作为妊娠高血压疾病早期识别和风险分层的非侵入性生物标志物的潜在作用。尽管结果未达到统计学显著性,但观察到的趋势支持脉络膜血管变化可能反映HDP潜在全身血管失调的假设。未来需要进行更大样本量和更长随访时间的研究,以验证这些发现并探索平均调整后的脉络膜厚度作为HDP严重程度和进展的预测标志物的效用。

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本文引用的文献

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Evaluation of Choroidal Thickness during Pregnancy and Postpartum: A Longitudinal Study.孕期及产后脉络膜厚度的评估:一项纵向研究。
J Curr Ophthalmol. 2022 Nov 30;34(3):312-317. doi: 10.4103/joco.joco_42_22. eCollection 2022 Jul-Sep.
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Subfoveal Choroidal Thickness in Pre-eclampsia.子痫前期患者的黄斑下脉络膜厚度
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Int J Ophthalmol. 2016 Aug 18;9(8):1200-6. doi: 10.18240/ijo.2016.08.18. eCollection 2016.

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