Performance of ophthalmic artery Doppler velocimetry in the complementary diagnosis of preeclampsia

Diniz, Angélica Lemos Debs; Menêses, Vítor Fernando Silva de Campos; Freitas, Márcia Aires Rodrigues de; Paes, Maria Marta Bini Martins; Naves, Welington Ued; Sass, Nelson

doi:10.1080/14767058.2021.2014452

Cited by 9 publications

(13 citation statements)

References 41 publications

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“…In four studies evaluated, the mean PI difference between overall PE and controls was − 0.48 (95% CI -0.59; -0.37), I2 36% with cut-offs established by the primary studies of 1.17 15 , 1.28 12 , 1.29 30 , and 1.30 13 (Supplement 11). In the mild PE group, there were seven studies with a mean difference of -0.62 (95% CI difference was − 0.87 (95% CI -1.20; -0.55), I2 = 94% with cut-offs of 1.00 14 , 1.02 15 , 1.13 34 , 1.14 33 , 1.17 34 , and 1.61 11 (Supplement 12).…”

Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 91%

“…The mean EDV difference for overall PE (four studies) was 3.09 (95% CI -1.13; 5.05), I2 = 84% with cut-offs of 9.90 30 , 7,45 13 , 7.90 15 , 9.20 12 cm/s. In the mild PE group (four studies), the mean difference was 2.37 (95% CI 0.62; 4.12), I2 = 76% with cut-offs of 8.20 33 , 9.51 15 , 11.92 14 , and 12.90 11 cm/s.…”

Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 95%

“…PVS showed low accuracy, and EDV demonstrated higher velocities in the PE group and good accuracy. The mean PSV difference for overall PE (four studies) was 1.71 (95% CI -2.88; 6.29), I2 = 76% with cut-offs of 28.96 15 , 37.60 13 , 40.35 30 , and 47.00 12 cm/s. In the mild PE group (four studies), the mean difference was − 0.36 (95% CI -3.32; 2.60), I2 = 48% with cut-offs of 28.44 15 , 30.60 32 , 34.35 14 , and 48.30 11 cm/s.…”

Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 95%

“…In seven studies evaluated, the mean RI difference for overall PE was − 0.07 (95% CI -0.09; -0.04), I2 = 81% with cut-offs established by the primary studies of 0.62 15 , 0.64 16 , 0.66 12,17 , 0.67 18 , and 0.68 13,30 (Supplement 8). In the mild PE group, there were seven studies with a mean difference of -0.02 (95% CI -0.14; 0.09), I2 = 99% with cut-offs of 0.63 31 , 0.641 4 , 0.66 15 , 0.73 32,33 , 0.77 11 , and 0.97 19 (Supplement 9).…”

Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 98%

“…This parameter was compared among cases and controls in three studies, and the mean difference was 0.24 (95% CI 0.15; 0.34). There was high heterogeneity, I2 = 90% (199 events), with cut-offs established by the primary studies of 0.75 12 , 0.81 13 , and 0.83 30 (Supplement 2). In the mild PE group, there were four studies with a mean difference of 0.21 (95% CI 0.11; 0.30), I2 = 92% (98 events) with cut-offs of 0.65 32 , 0.70 11 , 0.71 33 , 0.81 14, and in the severe PE group with four studies, the mean difference was 0.35 (95% CI 0.16; 0.38), I2 = 0% (90 events) with cut-offs of 0.81 11 , 0.84 14 , 0.85 33 , 0.89 32 (Supplement 3).…”

Section: Study Characteristics and Risk Of Biasmentioning

confidence: 99%

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Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis

Melo

Roever

Mendonça

et al. 2022

Preprint

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Objective: To evaluate the accuracy of different parameters of the ophthalmic artery Doppler (OAD) in the complementary diagnosis of preeclampsia (PE). Methods: This meta-analysis adhered to the PRISMA guidelines. To investigate the mean difference in OAD values, peak systolic velocity (PSV), end-diastolic velocity (EDV), second systolic velocity peak (P2), resistance index (RI), pulsatility index (PI), and peak ratio (PR), between PE cases (overall and according to severity) and controls, random-effects meta-analyses were conducted for each Doppler parameter, with overall PE and mild and severe PE subgroups. Diagnostic performance and heterogeneity were evaluated with summary receiver operating characteristic (sROC) curves and 95% confidence intervals obtained with bivariate models. Results: Eight studies stratified the results into mild and severe or late and early PE, involving 1,425 pregnant women. PR and P2 had better diagnostic performance than the other indexes, with the PR of AUsROC at 0.885, the sensitivity of 84%, and specificity of 92%, with a low false-positive rate of 0.08 and the P2 with AUsROC of 0.926, the sensitivity of 85% and specificity of 88%. RI, PI, and EDV showed good performance and consistency across studies but lower AUsROC values of 0.833, 0.794, and 0.772, respectively. Conclusion: Ophthalmic artery Doppler is a complementary tool with good performance for the diagnosis of overall and severe preeclampsia, with high and best sensitivity and specificity when using PR and P2 parameters.

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Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 91%

Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 95%

Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 95%

Section: Resistance Index(ri) and Pulsatility Index (Pi)mentioning

confidence: 98%

Section: Study Characteristics and Risk Of Biasmentioning

confidence: 99%

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Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis

Melo

Roever

Mendonça

et al. 2022

Preprint

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Hypertensive disorders of pregnancy and long‐term cardiovascular health: FIGO Best Practice Advice

Poon

Nguyen‐Hoang

Smith

et al. 2023

Intl J Gynecology & Obste

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Hypertensive disorders of pregnancy (HDP) are the most common causes of maternal and perinatal morbidity and mortality. They are responsible for 16% of maternal deaths in high‐income countries and approximately 25% in low‐ and middle‐income countries. The impact of HDP can be lifelong as they are a recognized risk factor for future cardiovascular disease. During pregnancy, the cardiovascular system undergoes significant adaptive changes that ensure adequate uteroplacental blood flow and exchange of oxygen and nutrients to nurture and accommodate the developing fetus. Failure to achieve normal cardiovascular adaptation is associated with the development of HDP. Hemodynamic alterations in women with a history of HDP can persist for years and predispose to long‐term cardiovascular morbidity and mortality. Therefore, pregnancy and the postpartum period are an opportunity to identify women with underlying, often unrecognized, cardiovascular risk factors. It is important to develop strategies with lifestyle and therapeutic interventions to reduce the risk of future cardiovascular disease in those who have a history of HDP.

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Ophthalmic Artery Doppler as a Predictor of Adverse Neonatal Outcomes in Women With Preeclampsia

Monteiro,

de Oliveira,

Gomes Junior

et al. 2024

J of Clinical Ultrasound

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ObjectiveThis study aimed to evaluate the association between ophthalmic artery (OA) Doppler indices and adverse neonatal outcomes in women with pregnancies complicated by preeclampsia (PE).MethodsA prospective cross‐sectional study involving 110 pregnant women who were diagnosed with PE in the first 24 h of hospitalization was conducted at three hospitals in southeastern Brazil from April 2020 to December 2022. The ophthalmic parameters analyzed were the resistance index (RI), pulsatility index (PI), first peak systolic velocity (PSV1), second peak systolic velocity (PSV2), ratio of PSV2 to PSV1 (PSV ratio or the peak ratio [PR]), and end‐diastolic velocity (EDV). The outcome measures were neonatal death (during hospitalization), neonatal intensive care unit (ICU) admission, gestational age at delivery < 32 weeks, birth weight < 1500 g, birth weight < 10th percentile, the presence of comorbidities associated with prematurity, the use of invasive mechanical ventilation, an Apgar score at the 5th minute < 7.0, and signs of neurological impairment.ResultsPregnant women with severe features of PE showed higher values of systolic (152.8 ± 20.7 vs. 136.3 ± 11.9, p = 0.000) and diastolic (98.1 ± 12.8 vs. 88.1 ± 10.8, p = 0.000) blood pressure values and lower gestational age at admission (31.5 ± 3.8 vs. 33.7 ± 4.3, p = 0.009) than PE without severe features. No significant differences were found between the mean values of the OA Doppler indices when comparing the presence or absence of neonatal outcomes in the women with PE.ConclusionsOA Doppler, while valuable for the prediction, diagnosis, and evaluation of adverse maternal outcomes, does not independently predict adverse neonatal outcomes in women with severe features of PE.

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Performance of ophthalmic artery Doppler velocimetry in the complementary diagnosis of preeclampsia

Cited by 9 publications

References 41 publications

Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis

Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis

Hypertensive disorders of pregnancy and long‐term cardiovascular health: FIGO Best Practice Advice

Ophthalmic Artery Doppler as a Predictor of Adverse Neonatal Outcomes in Women With Preeclampsia

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