Preeclampsia and the Retina
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Cited by 3 publications
References 30 publications
Retinal and Macular Changes in Pregnant Women of Advanced Maternal Age: A Retrospective Study
Aims/Background Pregnancy may cause physiological and pathological changes in multiple organs in a woman’s body, including the heart, liver, and eyes. With rapid advances in societies and economies, the proportion of advanced maternal age (AMA) women has significantly increased. Here, we aimed to investigate the changes in arteriole retinal diameter, venule diameter, macular layer thickness, and arteriole to venule ratio (AVR) in this population. Methods This retrospective case-control study included 523 pregnant women (1046 eyes) and was performed on both eyes. In total, 318 subjects were included in the AMA group, and 205 subjects were included in the non-AMA group. Nonmydriatic fundus photography and optical coherence tomography (OCT) were performed on the same day, and the results were analyzed for the central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), AVR, and macular thickness (9 subfields) by integrative vessel analysis and automatic OCT software. Results In both eyes, the CRAE was significantly lower in the AMA group than that in the non-AMA group (p < 0.05; respectively). The CRVE in the AMA group was higher than that in the non-AMA group (p < 0.001; respectively). Compared to the non-AMA group, the AMA group exhibited a significant reduction in macular thickness within the inner nasal, outer nasal, and inner temporal subfields of both eyes (p < 0.05; respectively). Age was significantly correlated with CRVE and AVR in both eyes of pregnant women (CRVE: p < 0.0001; AVR: p < 0.01). Conclusion This study reports variations in the diameter of the retinal vasculature and the thickness of the macula in women of AMA. It is important to consider these changes when interpreting the adverse eye outcomes experienced by women of AMA.
Retinal and Macular Changes in Pregnant Women of Advanced Maternal Age: A Retrospective Study
Aims/Background Pregnancy may cause physiological and pathological changes in multiple organs in a woman’s body, including the heart, liver, and eyes. With rapid advances in societies and economies, the proportion of advanced maternal age (AMA) women has significantly increased. Here, we aimed to investigate the changes in arteriole retinal diameter, venule diameter, macular layer thickness, and arteriole to venule ratio (AVR) in this population. Methods This retrospective case-control study included 523 pregnant women (1046 eyes) and was performed on both eyes. In total, 318 subjects were included in the AMA group, and 205 subjects were included in the non-AMA group. Nonmydriatic fundus photography and optical coherence tomography (OCT) were performed on the same day, and the results were analyzed for the central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), AVR, and macular thickness (9 subfields) by integrative vessel analysis and automatic OCT software. Results In both eyes, the CRAE was significantly lower in the AMA group than that in the non-AMA group (p < 0.05; respectively). The CRVE in the AMA group was higher than that in the non-AMA group (p < 0.001; respectively). Compared to the non-AMA group, the AMA group exhibited a significant reduction in macular thickness within the inner nasal, outer nasal, and inner temporal subfields of both eyes (p < 0.05; respectively). Age was significantly correlated with CRVE and AVR in both eyes of pregnant women (CRVE: p < 0.0001; AVR: p < 0.01). Conclusion This study reports variations in the diameter of the retinal vasculature and the thickness of the macula in women of AMA. It is important to consider these changes when interpreting the adverse eye outcomes experienced by women of AMA.
A Model to Predict the Risk of Adverse Ocular Outcomes in Pregnant Women
Aims/Background Pregnancy can affect various bodily functions, including metabolism, cardiovascular function, and eyesight. Pathological ocular changes observed during pregnancy are linked to the development of pregnancy-specific conditions, such as preeclampsia/eclampsia and gestational diabetes. This study aims to analyze clinical data disease history and maternal characteristics collected during pregnancy, to determine ocular parameters and develop a risk prediction model for adverse ocular outcomes. Methods We retrospectively analyzed the medical records of 760 pregnant women (1520 eyes) from September 2020 to September 2022 at The Third Affiliated Hospital of Guangzhou Medical University. We identified maternal variables that could influence adverse ocular outcomes, including maternal age, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), eclampsia, pre-eclampsia, uterine disease, fetal abnormalities, in vitro fertilization with embryo transfer, hypoproteinemia, and major comorbidities during pregnancy. Univariate and multivariate logistic regression analyses were conducted to evaluate the effects of these independent predictors on adverse ocular outcomes. Additionally, receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off probability with for optimal sensitivity and specificity. Results Eclampsia, pre-eclampsia, GDM, a history of chronic hypertension, and hypoproteinemia were identified as independent predictors of adverse ocular outcomes during pregnancy (p < 0.05). Maternal age, PIH, intrauterine growth retardation (IUGR), obesity, and pregnancy with immunoglobulin A nephropathy were predictors of moderate and severe retinal arteriole sclerosis during pregnancy (p < 0.05). Additionally, hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome were predictors of retinal hemorrhage and exudate during pregnancy (p < 0.05). The area under the ROC curve for adverse ocular outcomes were 0.75 and 0.74, respectively. Conclusion Our predictive model effectively forecasts adverse ocular outcomes during pregnancy, incorporating risk factors such as maternal age, eclampsia and pre-eclampsia, GDM, obesity, a history of chronic hypertension, hypoproteinemia, IUGR, pregnancy with immunoglobulin A nephropathy, and HELLP syndrome.
A model to predict the risk of adverse ocular outcomes in pregnant women
Purpose This study aims to analyze common clinical data obtained during pregnancy, disease history, and maternal characteristics to determine ocular parameters and develop a risk prediction model for adverse ocular outcomes. Methods We retrospectively analyzed the medical records of 760 pregnant women (1,520 eyes) from September 2020 to September 2022 at the Third Affiliated Hospital of Guangzhou Medical University. The maternal variables that could influence adverse ocular outcomes were identified, including maternal age, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), eclampsia and pre-eclampsia, uterine disease, fetal abnormalities, in vitro fertilization with embryo transfer, hypoproteinemia, and major comorbidities during pregnancy. Univariate and multivariate logistic regression analyses were performed to evaluate the effects of the independent predictors on adverse ocular outcomes. The receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off probability with optimum sensitivity and specificity. Results Eclampsia and pre-eclampsia, GDM, history of chronic hypertension, and hypoproteinemia were independent predictors of adverse ocular outcomes during pregnancy (P < 0.05). Maternal age, PIH, intrauterine growth retardation (IUGR), obesity, and pregnancy with immunoglobulin A nephropathy were predictors of moderate and severe retinal arteriole sclerosis during pregnancy (P < 0.05). Moreover, hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome was a predictor of retinal hemorrhage and exudate during pregnancy (P < 0.05). Adverse ocular outcomes showed area under the ROC curve values of 0.75 and 0.74. Conclusion Our predictive model could effectively predict adverse ocular outcomes during pregnancy, with the risk factors including maternal age, eclampsia and pre-eclampsia, GDM, obesity, history of chronic hypertension, hypoproteinemia, IUGR, pregnancy with immunoglobulin A nephropathy, and HELLP syndrome.
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