Longitudinal changes of ocular blood flow using laser speckle flowgraphy during normal pregnancy

Abstract

PurposeInnovative laser speckle flowgraphy (LSFG) enables noninvasive evaluation of retinal microcirculation and the usefulness has been reported in the field of ophthalmology. LSFG has allowed us to measure the real time changes of retinal blood flow without pupillary dilatations and contrast media. Herein, we investigated the change of retinal blood flow in normal pregnant women during gestation using LSFG.MethodsA prospective cohort study was conducted in 53 pregnant women who visited our institution between January, 2013 and July, 2014. Finally, a total of 41 participants without any obstetric complications were available for evaluation. Retinal blood flow was measured with LSFG in a total of 4 times during pregnancy (T1. 11–13 weeks, T2. 19–21 weeks, T3. 28–30 weeks, T4. 34–36 weeks) and mean blur rate (MBR), blowout score (BOS), flow acceleration index (FAI), and resistive index (RI) are analyzed from these measurements. Relations between LSFG parameters and mean arterial blood pressure (MAP) are determined throughout pregnancy.ResultsMBR showed no significant changes throughout pregnancy. BOS showed a tendency to increase in the 3rd trimester. FAI values showed a slight increase from the 1st to 2nd trimester while a significant decrease was noted in the 3rd trimester. RI exhibited no changes between the 1st and 2nd trimesters, values decreased significantly after the 3rd trimester. MAP was positively correlated with BOS, and negatively correlated with FAI and RI.ConclusionThe present study clearly demonstrated that profiles of LSFG parameters demonstrated a decrease of resistance in retinal blood vessels. These changes in indices provide a highly sensitive reflection of physiological changes in vascular resistance due to pregnancy. Thus, LSFG may be useful, as a non-invasive, diagnostic tool to detect pregnancy related disorders such as preeclampsia.

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

“…Our findings are consistent with the observation of reduced vascular resistance in transcranial Doppler studies of the cerebral arteries of women with PE reported by Riskin‐Mashiah et al 18 and in the ophthalmic artery by Hata et al 19 , 20 and Diniz et al 21 Sato et al 22 reported declining vascular resistance and an inverse correlation with MAP in the retinal vessels in late pregnancy in normal subjects using laser Doppler flowmetry. Alves Borges et al 23 reported reduced resistance in the ophthalmic artery in post-partum PE versus control subjects.…”

Evaluation of flicker induced hyperemia in the retina and optic nerve head measured by Laser Speckle Flowgraphy

“…Beside these new approaches, Laser speckle flowgraphy (LSFG) has gained much interest for the assessment of ocular perfusion in humans. [21, 22] [23–25] The fact that LSFG is a non-invasive and FDA approved method for the assessment of retinal blood flow with short measuring times makes it an attractive approach for the assessment of neuro-vascular coupling in humans. In addition, the LSFG technique offers the possibility to assess changes in blood flow with high temporal and spatial resolution.…”

Changes in choroidal circulation and pulse waveform in a case of pregnancy-induced hypertension with serous retinal detachment

“…However, a previous study in an uncomplicated pregnancy showed no change in the retinal blood flow throughout. 20 On the other hand, the retinal blowout score tended to increase, and resistivity index significantly decreased between 28 and 30 weeks of pregnancy. The contradictory findings in the current case might be related to differences in the elevation of blood pressure and the differences in the autoregulatory capacity of the retina and choroid.…”