Retinal Vascular Changes During Pregnancy Detected With Optical Coherence Tomography Angiography

Abstract

PURPOSE. To evaluate retinal vascular status during pregnancy by using optical coherence tomography angiography (OCTA). METHODS. Women in their third trimester of pregnancy and nonpregnant age-matched women were recruited for this prospective, case-control study. Subjects were imaged with OCTA. Main outcome measures were foveal avascular zone parameters, perfusion density (PD) percentage in the superficial retinal capillary plexus (SCP), PD percentage in the deep retinal capillary plexus (DCP), SCP vessel length density (VLD), DCP-VLD, and choriocapillaris (CC) flow voids (i.e., flow deficits in the CC). RESULTS. Nineteen eyes of 10 pregnant subjects and 44 eyes of 27 nonpregnant control women were included. Mean ages were 36 6 7 and 35 6 8 years (SD), respectively (P value ¼ 0.78). Mean gestational age of pregnant women was 33 weeks (range ¼ 29-39, SD ¼ 3). There was a significant reduction in the SCP-PD in the entire scan and in the nasal Early Treatment Diabetic Retinopathy Study subfield (47.9 vs. 49.7, P ¼ 0.04 and 49.3 vs. 51.6, P ¼ 0.03, respectively) in the pregnant cohort versus controls. There was a significant increase in the DCP-PD in the parafoveal region and in the temporal and inferior Early Treatment Diabetic Retinopathy Study subfields (58.0 vs. 55.9, P ¼ 0.03; 57.9 vs. 55.5, P ¼ 0.02; 58.0 vs. 55.9, P ¼ 0.05, respectively) in the pregnant cohort. There was no significant difference in foveal avascular zone parameters, SCP-VLD, DCP-VLD, or CC flow voids between the two populations. CONCLUSIONS. This study detected retinal vasculature changes in the third trimester of pregnancy. Mean SCP-PD was significantly decreased and mean DCP-PD was significantly increased without a difference in VLD.

Maternal Optical Coherence Tomography Angiography Changes Related to Small for Gestational Age Pregnancies

“…Our previous study found that in the third trimester of normal pregnancy, mean perfusion density of the SCP significantly decreased and mean perfusion density of the DCP significantly increased without a difference in vessel length density compared with nonpregnant controls using the RTVue XR Avanti OCT device with AngioVue software. 10 The present study demonstrated that both VD and VDL in the nasal subfield of the SCP and ICP layers was significantly higher in the SGA group compared with the AGA group.…”

“…By using OCTA, our group found that the retinal vascular area increases in the third trimester of a normal pregnancy compared to nonpregnant controls. 10 We hypothesized that increased total body blood volume and high levels of progesterone associated with pregnancy may result in physiological retinal capillary dilation during normal pregnancy. It is unknown, however, whether additional retinal vascular changes can occur in the setting of SGA.…”

Evaluation of the Choroid in Women with Uncomplicated Pregnancy

“…Using OCTA, our previous studies found that perfusion density in superficial retinal capillary plexus (SCP) significantly decreased and perfusion density in deep retinal capillary plexus (DCP) significantly increased in the third trimester of pregnant women compared with nonpregnant controls. 28 We hypothesized that the retinal microvasculature adapts by vasodilation during pregnancy due to hematological, vascular, and endocrine changes. Ciloglu et al 27 found that retinal microvascular structure changed in pregnant women with preeclampsia compared with uncomplicated pregnant women and nonpregnant controls.…”

Chorioretinal Alterations Induced by Preeclampsia

“…Using optical coherence tomography angiography (OCTA) to quantitatively monitor choriocapillaris flow has gained popularity in recent studies. Chanwimol et al [48] found that the choriocapillaris flow was not significantly different between pregnant women and nonpregnant women. However, Urfalıoglu [49] Journal of Ophthalmology analyzed the choriocapillaris flow area (CBPA) in PE pregnant women, healthy pregnant women, and control nonpregnant women.…”