Circumpapillary retinal nerve fiber layer thickness in hypertensive pregnancy disorder compared to a physiological course of pregnancy

Abstract

Purpose : Preeclampsia, pregnancy-induced hypertension and chronic hypertension can be summarized as hypertensive pregnancy disorders (HPD) and are the leading cause of maternal and fetal morbidity and mortality worldwide. The incidence of HPD is increasing and is currently around 10%. However, it is currently unknown how the physiological and pathological courses of pregnancy influence the retinal circumpapillary nerve fiber layer thickness (cpRNFLT).

Methods : Reliable (quality ≥20 dB, ≥50 B-scan repetitions) spectral-domain optical coherence tomography (SD-OCT, Spectralis, Heidelberg Engineering, Germany) cpRNFLT scans (768 A-scans) were selected from 107 healthy pregnant women and 36 with HPD in the third trimester (28.0 to 42.0 weeks of pregnancy) as well as from 9 healthy non-pregnant controls of reproductive age. The results were adjusted for maternal age, refraction and gestational age at the time of measurement. HPD was defined according to the German guidelines. In all groups only singleton pregnancies were considered for analysis. Women with gestational diabetes, manifest diabetes mellitus type 1 or 2 were excluded.

Results : Compared to healthy non-pregnant women, women with a physiological course of pregnancy showed significantly (red) thicker cpRNFLT in the nasal superior area (Fig. 1A), while women with HPD showed significantly thicker cpRNFLT especially in the inferotemporal region compared to healthy non-pregnant women (Fig. 1B). Currently, we found no significant difference in cpRNFLT between the groups of healthy pregnant women and pregnant women with HPD (Fig. 1C).

Conclusions : We found a significant increase of the cpRNFLT in both physiological and HPD pregnancies compared to healthy non-pregnant controls. This can be interpreted as an expression of the enormous metabolic and circulatory adaptation of the body to pregnancy. Longitudinal changes in cpRNFLT should be examined immediately postnatally and 6 months postpartum in order to assess the regression of these processes.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Fig. 1