Comparison of Choroidal Thickness in Preeclamptic, Healthy Pregnant, and Nonpregnant Women: A Systematic Review and Meta-Analysis

Abstract

<b><i>Purpose:</i></b> To compare the choroidal thickness (CT) measured by enhanced depth imaging optical coherence tomography (EDI-OCT) in preeclamptic, healthy pregnant, and healthy nonpregnant women. <b><i>Methods:</i></b> Studies that focused on the CT evaluation of pregnant women were retrieved by searching PubMed, Embase, Ovid, Cochrane, and Web of Science. We used Stata 14.0 SE for the meta-analysis and presented the results as the weighted mean difference (WMD) with a corresponding 95% CI. <b><i>Results:</i></b> A total of 14 studies with 1,227 participants were included in our meta-analysis. The CT of the healthy pregnancies (μm, WMD = 34.19, 95% CI: 20.63–47.76) was significantly higher than that of the nonpregnancies (Test of WMD = 0: <i>z</i> = 4.94, <i>p</i> = 0.000), but the CT of the preeclampsia (μm, WMD = 54.30, 95% CI: –13.40 to 122.01) was not significantly different from the nonpregnancies (Test of WMD = 0: <i>z</i> = 1.57, <i>p</i> = 0.116). In the preeclampsia versus healthy pregnancy group, 3 studies found that the choroid was thinner with preeclampsia, only one study found the CT increased. <b><i>Conclusions:</i></b> This meta-analysis suggested that the CT of the healthy pregnant women was significantly higher than that of the nonpregnant women. The presence of preeclampsia might complicate this situation. Most studies found that the CT decreased in the preeclamptic patients because of the increases in the systemic vasospasm and the blood pressure, which led to no significant difference compared with the nonpregnant women.

Central serous chorioretinopathy: An update on risk factors, pathophysiology and imaging modalities

“…The choroid is one of the most highly vascularised tissues, with the highest blood flow to tissue volume ratio in the whole body, therefore during pregnancy there is an expectation that it would respond to increased blood flow by increasing its thickness (Alm and Bill 1972). In fact, one meta-analysis reported the choroidal thickness of healthy pregnant women to be significantly higher than that of non-pregnant women (Jiang et al 2019). Pregnancy can be a triggering event for CSC, and in both pregnancy and CSC the choroid is thought to be thicker (Liu et al 2016a).…”

Chorioretinal Alterations Induced by Preeclampsia

“…e characteristics of the included studies are shown in Table 1. A metaanalysis of 1227 pregnant women demonstrated that the choroidal thickness of the normal pregnancy group was significantly higher than that of the nonpregnant group [42]. It was speculated that this may be related to the increasing circulating volume or alterations in hormone levels during pregnancy.…”

Evaluation of Choroidal Thickness during Pregnancy and Post-partum: A Longitudinal Study

“…There is no de nite consensus on whether pregnancy can change choroidal structure and thickness and whether these changes are reversible. analysis concluded that choroidal thickness is signi cantly higher in healthy pregnant patients over 24 weeks of GA compared to controls [30].…”

“…The mean age was 26.1±3.6 years (range, [22][23][24][25][26][27][28][29][30][31][32][33][34] at the time of the rst examination in the pregnant group and 26.7±4.0 (range, [21][22][23][24][25][26][27][28][29][30][31][32][33][34] in the control group. Intraocular pressures (IOP) were within the normal range in both groups.…”