Relationship between proteinuria and optical coherence tomographic features of the chorioretina in patients with pre-eclampsia

Abstract

This retrospective study aimed to evaluate the correlation between ophthalmologic factors and proteinuria in patients with pre-eclampsia using swept-source optical coherence tomography (OCT) and OCT angiography. In total, 61 pregnant patients diagnosed with pre-eclampsia were recruited during their hospital stay. The authors investigated the relationship between urine protein–creatinine ratio (PCR) and chorioretinal measurements including choroidal thickness (CT), choroidal vascularity index (CVI), foveal avascular zone (FAZ), vascular density (VD), ganglion cell layer+ (GCL+) and GCL++. The associations between mean arterial pressure (MAP) and ophthalmologic factors were also evaluated. Central subfield CT of the right eye (p = 0.031) and paracentral CT of both eyes were related to higher PCR (≥1.35 mg/mg). A significant association with PCR after logarithm transformation was noted (r = 0.284, p = 0.026). Retinal measurements (FAZ, VD, GCL+ and GCL++) and CVI were not related with PCR. There was a positive association between MAP and PCR after logarithm transformation (r = 0.296, p = 0.021); however, chorioretinal factors were not related with MAP. In pregnant women with pre-eclampsia, CT using OCT is a novel factor that is correlated with PCR. Ocular structural alteration in patients with pre-eclampsia may be one of systemic vascular changes caused by pre-eclampsia rather than hypertension.

Relationship between the sFlt-1/PlGF ratio and the optical coherence tomographic features of chorioretina in patients with preeclampsia

“…Moreover, in our study, no significant correlation was found between CT and systolic, diastolic BP. This finding is consistent with the previous report speculating that the chorioretinal pathology and hypertension are independent results of systemic imbalance, although systemic imbalance of vascular factors affects both BP and ocular vascular condition, and the CT is not directly associated with BP, but associated with protein-creatinine ratio (PCR) in preeclampsia [ 24 ].…”

“…Still, the increase in CT in preeclampsia was lower than that in healthy pregnant controls, which attributed to the markedly increased systemic vascular vasospasm secondary to preeclampsia [ 30 ]. Shim et al suggested that there was a positive correlation between CT in preeclampsia and PCR in urine, implying preeclampsia severity [ 24 ]. This suggestion may be inconsistent with our findings, because it is a paradox that the changes of CT according to those of PCR and sFlt-1/PlGF ratio have opposite directions though both PCR and sFlt-1/PlGF ratio are indicators implying severe preeclampsia.…”

Relationship between proteinuria and changes in antepartum and postpartum choroidal thickness in patients with pre-eclampsia

“…This apoptosis has been found to be positively correlated with the sFlt1/PlGF ratio, which is considered indicative of endothelial damage [21]. In support of these ndings, our previous study established a relationship between logPCR and the sFlt1/PlGF ratio with CT in women with PE [13,22]. This relationship is further corroborated by the results of the present study.…”

Relationship between proteinuria and changes in antepartum and postpartum choroidal thickness in patients with pre-eclampsia

“…This apoptosis has been found to be positively correlated with the sFlt1/PlGF ratio, which is considered indicative of endothelial damage 21 . In support of these findings, our previous study established a relationship between antepartum logPCR and the sFlt1/PlGF ratio with CT in women with PE 13 , 22 . This relationship is further corroborated by the results of the present study.…”

“…The spot (random) urine protein-creatinine ratio (PCR, with a normal range of < 0.3 mg/mg) is typically used to assess quantitative proteinuria 12 . Our previous work indicated a correlation between CT and the PCR 13 ; however, to the best of our knowledge, no studies have explored the relationship of antepartum and postpartum CT with the PCR. Therefore, this study aimed to evaluate the correlation between antepartum and postpartum CT and the PCR in patients with PE.…”