Ocular vascular changes during pregnancy: an optical coherence tomography angiography study

Kızıltunç, Pınar Bingöl; Varlı, Bulut; Büyüktepe, Tuna Çelik; Atilla, Hüban

doi:10.1007/s00417-019-04541-6

Cited by 21 publications

(16 citation statements)

References 23 publications

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“…It has been reported that there is a relationship between foveal avascular zone (FAZ) values and vascular indices, and age, gender, axial length (AL), spherical equivalent (SE), body mass index (BMI), and central macular thickness (CMT) in a healthy population (8)(9)(10)(11). It has also been noted that OCTA parameters vary according physiological conditions, such as pregnancy (12). In the majority of OCTA studies of healthy subjects, AL and BMI differences of the participants were not considered (13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Normative Data of Superficial Retinal Vascular Plexus and Its Relationship with Retinal Layers

Işık¹

2021

Beyoglu Eye J

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Objectives:The aim of this study was to evaluate the relationship between optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) parameters in a healthy population and to detect any changes that occur with age. Methods: A total of 100 healthy participants were included in this prospective, observational, and comparative study. The participants were categorized in 4 groups according to age: Group 1: 21-30 years, Group 2: 31-40 years, Group 3: 41-50 years, Group 4: 51-60 years of age. Mean macular thickness, retinal nerve fiber layer (RNFL), ganglion cell inner plexiform layer (GC-IPL), and the choroidal thickness (ChT), vessel density (VD), perfusion density (PD), foveal avascular zone (FAZ), and parapapillary perfusion density parameters were recorded and analyzed. Results: In comparisons between groups, no significant difference in OCTA parameters was observed. There were inverse correlations between the outer VD, PD, and intraocular pressure (IOP) (r= -0.307, p=0.006 and r= -0.284, p=0.011, respectively). The correlation between parapapillary perfusion density and IOP was close to being significant (r= -0.213, p=0.059). There were significant relationships between OCTA parameters and macular, RNFL, and GC-IPL thickness. No significant relationship between ChT and OCTA parameters was seen. Conclusion:The size and characteristics of superficial VD, PD, parapapillary perfusion density, and FAZ were determined in a population with standardized demographic and ocular clinical features, and the relationship between these parameters and retinal layers was established.

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Section: Introductionmentioning

confidence: 99%

Normative Data of Superficial Retinal Vascular Plexus and Its Relationship with Retinal Layers

Işık¹

2021

Beyoglu Eye J

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“…Only two studies related to these pregnancy-related changes have been published in the literature. In their study including women in all trimesters of pregnancy, Kızıltunç et al 11 reported that pregnant women showed increases in FAZ area and VD in both plexuses. However, they observed no significant differences when compared by trimester.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography study

Yildirim

Kurt

Altınışık

et al. 2020

European Journal of Ophthalmology

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Introduction: The structural and vascular changes in the retina and choroid in women in the third trimester of pregnancy were analyzed using optical coherence tomography angiography (OCTA). Methods: Forty women in the third trimester of uncomplicated pregnancy and 40 age-matched healthy women were included. Vascular density (VD) in the superficial and deep capillary plexuses (SCP/DCP), foveal density (FD), and foveal avascular zone (FAZ) area and perimetry measured with OCTA, as well as OCT measurements of central macular thickness (CMT) and choroidal thickness (CT) were compared between the groups. Correlations between structural OCT parameters and vascular OCTA metrics were analyzed. Results: The mean gestational age was 34 (28–41) weeks. Mean age was comparable in the groups ( p = 0.732). The pregnant women had significantly higher parafoveal DCP-VD ( p = 0.015), FAZ area ( p = 0.044), and FD ( p = 0.002). Mean subfoveal CT was 21 µm higher in pregnant women but was not significant ( p = 0.472). There was no difference in CMT ( p = 0.448). FAZ metrics were positively correlated with CT in pregnants and with CMT in the control group ( p < 0.05). Parafoveal VD was negatively correlated with CT in the control group ( p < 0.05). After adjusting for CT and CMT, the significant difference in VD and FD persisted ( p < 0.05), while the difference in FAZ area lost significance ( p > 0.05). Conclusions: Considering the effects of the probable covariant factors CMT and CT, systemic changes in pregnant women in their third trimester may cause an increase in VD in the macula and parafoveal DCP.

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“…Optical coherence tomography angiography (OCTA) in pregnancy has shown a decrease in superficial capillary plexus, perfusion density (SCP-PD), and an increase in deep capillary plexus density, perfusion density (DCP-PD), without changes in vessel length density in one study[ 43 ] and increase in both SCP (parafoveal and perifoveal area) and DCP in macular area in the pregnant group in another study. [ 44 ] There was more capillary dropout in SCP in the diabetic group probably due to hyperglycemia, which got better after delivery, and an increase in DCP in both diabetic and nondiabetic groups in the parafoveal area. [ 45 ] Okada et al .…”

Section: Hyperglycemia In Pregnancymentioning

confidence: 99%

Diabetic retinopathy in pregnancy - A review

Chandrasekaran

Madanagopalan

Narayanan

2021

Indian Journal of Ophthalmology

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Diabetes and gestational diabetes (GD) are areas of concern worldwide. GD can eventually lead to serious development of diabetic retinopathy (DR) during pregnancy or worsening of an already existing DR. GD confers future risk of diabetes, both in the mother and fetus, further complicating their lives. DR in pregnant women has been intriguing in terms of understanding the prevalence, assessing risk factors causing pathogenesis, and problems associated with treating them. Pregnancy itself is a risk factor for progression of DR. Physiological changes such as metabolic, vascular, immunologic, and hormonal changes that occur during pregnancy can cause development as well as worsening of DR. This can eventually lead to permanent visual loss if not addressed on time. Timing of laser, choice of treatment for diabetic macular edema with laser, intravitreal anti-vascular endothelial growth factor agents (VEGF), and intravitreal steroids pose a serious challenge in managing these patients without causing damage to the mother and fetus. This review article showcases the prevalence, risk factors, and pathogenesis, outlines the management of DR in pregnancy, and recommends guidelines based on the available evidence. PubMed and MEDLINE searches were performed pertaining to the prevalence of GD in India, DR in pregnancy, risk factors for progression of DR, role of vasoactive mediators in DR, role of angiopoietic factors in DR, hormonal influence of DR, role of growth factors in DR, use of fluorescein and indocyanine green angiography, retinal lasers, anti-VEGF agents, intravitreal steroids, anesthesia, and retinal surgery, all pertaining to pregnancy and guidelines and recommendations for managing DR in pregnancy.

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Ocular vascular changes during pregnancy: an optical coherence tomography angiography study

Cited by 21 publications

References 23 publications

Normative Data of Superficial Retinal Vascular Plexus and Its Relationship with Retinal Layers

Normative Data of Superficial Retinal Vascular Plexus and Its Relationship with Retinal Layers

Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography study

Diabetic retinopathy in pregnancy - A review

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