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

Abstract

This study aimed to evaluate the correlation between ophthalmologic factors and the serologic indicator soluble fms-like tyrosine kinase 1 (sFlt-1): placental growth factor (PlGF) ratio in patients with preeclampsia using optical coherence tomography (OCT) and OCT angiography (OCT-A). A total of 52 pregnant patients (104 eyes) diagnosed with preeclampsia were recruited during their hospital stay. The associations between the sFlt-1/PlGF ratio and chorioretinal measurements, including the choroidal thickness (CT), foveal avascular zone, vascular density, and ganglion cell layer+ were evaluated. Central and nasal subfield CT of the left eye (p = 0.039; p = 0.010) and nasal subfield CT of the right eye (p = 0.042) were lower in the high sFlt-1/PlGF ratio group (≥38). Pearson’s correlation test showed a negative correlation between the sFlt-1/PlGF ratio and central subfield CT; however, this was not statistically significant (p = 0.648). Linear regression analysis revealed a significant association between the sFlt-1/PlGF ratio and central subfield CT (β coefficient, -6.66; p = 0.01) and between sFlt-1 and central subfield CT (β coefficient, -5.65; p = 0.00). Thus, an increase in the sFlt-1/PlGF ratio resulted in a decrease in central subfield CT.

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.…”

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“…Thus, placental vascular growth is tempered by an increase in anti-angiogenic sFlt-1 and a decrease in angiogenic VEGF and PlGF levels. However, in women with preeclampsia, sFlt-1 increases earlier in gestation and reaches a higher concentration than in normal pregnancy" [7]. Increasing levels of sFlt-1 will cause vasoconstriction in the choroid and reduced choroidal vessel permeability, causing the optic changes we saw on fundoscopy.…”

“…The pathophysiology is not completely understood but thought to be due to abnormal placental perfusion [2]. Many pathologic changes are seen in the affected organs, including glomerular endotheliosis in the kidneys and increased central corneal thickness and corneal curvature, decreased corneal sensitivity, and intraocular pressure [3][4][5][6][7]. Many risk factors have been identified for preeclampsia including nulliparity, multifetal gestations, history of preeclampsia in prior pregnancies, chronic hypertension, both pregestational and gestational diabetes, thrombophilia, systemic lupus erythematosus, pre-pregnancy body mass index greater than thirty, antiphospholipid syndrome, advanced maternal age, kidney disease, assisted reproductive technologies, and obstructive sleep apnea [8].…”

Shear wave elastography combined with two‐dimensional ultrasonography for detecting optic nerve sheath: An effective tool for assessing preeclampsia

“…6,7 Visual symptoms are reported in approximately 40% of patients with preeclampsia and can include decreased acuity, field defects, increased central corneal thickness and curvature, decreased corneal sensitivity, and decreased intraocular pressure. [8][9][10] Preeclampsia is associated with changes in the blood-eye barrier, choroidal thickness, and circulation, leading to varying degrees of ocular pathology. [11][12][13][14] Timely diagnosis and treatment of cerebral edema, aiming to decrease intracranial pressure (ICP), have been shown to significantly impact morbidity and mortality.…”

“…This, in turn, leads to increased systemic vascular resistance and endothelial dysfunction 6,7 . Visual symptoms are reported in approximately 40% of patients with preeclampsia and can include decreased acuity, field defects, increased central corneal thickness and curvature, decreased corneal sensitivity, and decreased intraocular pressure 8–10 . Preeclampsia is associated with changes in the blood‐eye barrier, choroidal thickness, and circulation, leading to varying degrees of ocular pathology 11–14 .…”