Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography

Urfalioglu, Selma; Bakacak, Murat; Özdemir, Gökhan; Güler, Mete; Beyoğlu, Abdullah; Arslan, Guven

doi:10.1016/j.preghy.2019.07.001

Cited by 14 publications

(14 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The seeming contradiction between our finding of decreased orbital and choroidal resistance with some reports of retinal vasoconstriction in PE might be addressed in future studies using ultrasound scanning in conjunction with OCT-A. Although OCT-A cannot at present measure flow dynamics, it has allowed demonstration of subtle structural changes in the retina 38 and choriocapillaris 39 in PE. Swept-source OCT-A is particularly adept in imaging and characterizing the choriocapillaris.…”

Section: Discussioncontrasting

confidence: 79%

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Silverman

Urs

Wapner

et al. 2020

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

Purpose Pre-eclampsia (PE) is a serious complication of pregnancy characterized by high blood pressure, proteinuria, compromised fetal blood supply, and potential organ damage. The superficial location of the eye makes it an ideal target for characterization hemodynamics. Our aim was to discern the impact of PE on ocular blood flow. Methods 18 MHz plane-wave ophthalmic ultrasound scanning was performed on subjects with PE (n = 26), chronic or gestational hypertension (n = 8), and normal controls (n = 19) within 72 hours of delivery. Duplicate three-second long scans of the posterior pole including the optic nerve were acquired at 6000 images/sec for evaluation of the central retinal artery and vein and the short posterior ciliary arteries. The choroid was scanned at 1000 images/sec. Doppler analysis provided values of pulsatile flow velocity and resistance indexes. Results End diastolic velocity was higher, and pulsatility and resistive indexes were significantly lower in the choroid, central retinal artery and short posterior ciliary arteries in PE than in controls. Blood pressure was elevated in PE with respect to controls and was negatively correlated with resistance. Conclusions Although vasoconstriction is considered characteristic of PE, we found reduced resistance in the orbital vessels and choroidal arterioles, implying vasodilation at this level. Future studies incorporating optical coherence tomography angiography for characterization of the retina and choriocapillaris in conjunction with plane-wave ultrasound scanning, particularly in late pregnancy, might address this conundrum. Translational Relevance Use of plane-wave ultrasound scanning for evaluation ocular blood flow in women at risk for PE may offer an avenue towards early detection and clinical intervention.

show abstract

Section: Discussioncontrasting

confidence: 79%

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Silverman

Urs

Wapner

et al. 2020

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

show abstract

“…They explain these results with the fact that retinal vessels are not dependent on the autonomic nervous system, having their own autoregulatory mechanism, while choroidal flow varies in proportion to systemic blood flow when BP is increased (Urfalioglu et al. 2019).…”

Section: Resultsmentioning

confidence: 99%

“…Preeclampsia Preeclampsia (PE) is defined by proteinuria, HTN and multiorgan failure during pregnancy (Urfalioglu et al 2019). This condition leads to endothelial dysfunction and vasoconstriction which, in turn, cause systemic HTN and endorgan hypoperfusion.…”

Section: Obstructive Sleep Apnoea Syndromementioning

confidence: 99%

Optical coherence tomography angiography changes in cardiovascular systemic diseases and risk factors: A Review

Monteiro-Henriques

Rocha‐Sousa

Breda

2021

Acta Ophthalmologica

View full text Add to dashboard Cite

Cardiovascular (CV) disease (CVD) is the main cause of death around the world, and assessing a patient’s CV risk factors (CVRF) can play a major role in its prevention. Since it has been shown that retinal vascular alterations may reflect several systemic processes such as CVRF, we conducted a systematic review in order to summarize which ocular microvasculature changes can be found using Optical Coherence Tomography Angiography (OCTA) in patients without ocular diseases and with systemic pathologies/conditions that affect the CV system when compared to healthy subjects. We searched on online databases, namely PubMed, Scopus, Cochrane and Web of Science, and obtained additional studies through citation tracking. Case reports and review articles were excluded. A total of 47 articles were included in our review. We describe that patients with hypertension, diabetes mellitus, kidney disease, preeclampsia, coronary artery disease, carotid artery stenosis and obstructive sleep apnoea syndrome have, in general, lower retinal and choroidal Vessel Density (VD) and Length (VL), as well as an increased foveal avascular zone area and perimeter. Additionally, several characteristics and/or conditions in healthy subjects, such as smoking status, hyper or hypoxia conditions, race, among others, are also related to ocular vascular changes and should be accounted for. We concluded that OCTA could be a useful tool to assess a patient’s CV risk profile in a non‐invasive way, possibly integrating the diagnostic and prognostic algorithms of the most prevalent CV diseases in the future.

show abstract

“…ere was no significant difference in the foveal avascular zone (FAZ). Urfalioglu et al [49] found that the area of blood vessels around the optic nerve was significantly reduced compared with that of the control group, reflecting the lack of substantial blood flow around the optic nerve in PE patients. is may be related to the mechanism of hypoperfusion or vasoconstriction generated by hyperperfusion injury.…”

Section: Hypertensive Retinopathymentioning

confidence: 97%

“…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. e outcome indicated that CBPA was higher in both groups of pregnant women than in the control group of nonpregnant women.…”

Section: Hypertensive Choroidopathymentioning

confidence: 99%

Chorioretinal Alterations Induced by Preeclampsia

et al. 2021

Journal of Ophthalmology

View full text Add to dashboard Cite

Hypertension during pregnancy, which is essentially a microvascular disease that destroys the end-organ microcirculation, should not be underestimated, as it could lead to organ failure in the kidneys, lungs, and brain. Preassessment of the microcirculatory state through systematic observation of the fundus has been proven to be noninvasive and feasible. Although hypertension in preeclampsia patients will resolve after childbirth, the sticking point is determining the best termination moment. Early diagnosis and treatment can prevent long-term ocular complications and cardiovascular risks for pregnant women in the future. In order to adjust the treatment strategy through more sensitive and precise fundus changes, we comprehensively summarized the common structural changes in the fundus in preeclampsia patients, including changes in the blood vessels, choroid, and retina, as well as the application of quantitative observation for chorioretinal alterations in recent years.

show abstract

Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography

Cited by 14 publications

References 28 publications

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

Optical coherence tomography angiography changes in cardiovascular systemic diseases and risk factors: A Review

Chorioretinal Alterations Induced by Preeclampsia

Contact Info

Product

Resources

About