Corneal thickness is not increased in severe preeclampsia compared with normotensive controls

Abstract

Purpose : Visual disturbances complicate approximately 40% of preeclampsia cases, and are even used as part of the diagnostic criteria of severe preeclampsia (sPE). The majority of preeclampsia cases, however, lack changes evident on clinical exam. We tested whether central corneal thickness (CCT) differed between subjects diagnosed with sPE and normotensive controls in the immediate postpartum period using standard pachymetry.

Methods : In this IRB approved, matched case-control study, we recruited 25 subjects with sPE (cases) and 27 with normotensive pregnancies (NP; controls) during the postpartum period. Controls were matched to sPE cases on parity and race/ethnicity. Women with a clinical diagnosis of chronic or gestational hypertension, or those diagnosed with pregestational or gestational diabetes were excluded from the study. Pachymetry was used to measure corneal thickness at the center of the pupil. Any subjective visual disturbances experienced in the peripartum period were noted.

Results : Severe preeclampsia cases and normotensive controls were examined, on average, at a median (range) of 3 (1-14) and 2 (1-3) days postpartum, respectively (P<0.001). Mean (± standard deviation) CCT was 544 ± 44 µm (range 431-625) and 557 ± 25 µm (range 504-600) in sPE cases and NP controls, respectively (P=0.07). Of sPE cases, 14 (56%) reported visual changes as compared to 1 (3.7%) in the control group (P<0.001). Two-tailed Student’s t-test was used for statistical analyses.

Conclusions : These findings demonstrate a trend toward decreased CCT measurements in women with sPE compared to normotensive women in the immediate postpartum period. Further studies designed with a larger number of patients and matched examination time between cases and controls are necessary. Importantly, the role of hormonal and angiogenic factors that shape the association between CCT and preeclampsia may be targets worthy of investigation.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.