Diminished choroidal blood flow in hypertensive and preeclamptic third trimester pregnancies using optical coherence tomography angiography

PurposeThe aim of this study was to compare choroidal adjusted flow index (AFI) in healthy, hypertensive & preeclamptic pregnancies using optical coherence tomography angiography (OCTA). MethodsIn this prospective study, healthy, hypertensive & preeclamptic third trimester pregnant women underwent OCTA imaging. 3x3 & 6x6 mm choriocapillaris slabs were exported and the parafoveal area was marked by two concentric ETDRS circles at 1 & 3 mm, centered on the foveal avascular zone. Parafoveal AFI was calculated as a parameter of choroidal blood flow. ResultsFifteen eyes of fifteen women per group were recruited (45 eyes). AFI was significantly lower in the preeclamptic compared to the healthy & hypertensive groups (Tukey HSD: <0.001 in both groups on 3x3 mm, and 0.02 & 0.04 in 6x6 mm scans), and in the hypertensive compared to the healthy group (0.005 & 0.03 in 3x3 & 6x6 mm scans respectively). ConclusionsPregnancies complicated with preeclampsia revealed the lowest choroidal blood flow on OCTA followed by pregnancies with systemic hypertension compared to healthy pregnancies. We provide in-vivo documentation of choroidal ischemia, highlighting its culpability in hypertensive and preeclamptic retinochoroidal pathology, and the possibility of utilizing choroidal blood flow on OCTA as a precursor for disease progression.

Automated summary

The purpose of this study was to compare choroidal adjusted flow index (AFI) in healthy, hypertensive, and preeclamptic pregnancies using optical coherence tomography angiography (OCTA). OCTA imaging was performed on third trimester pregnant women in each group. The results showed that preeclamptic pregnancies had the lowest AFI, followed by hypertensive pregnancies, compared to healthy pregnancies. The study found that choroidal ischemia may be responsible for hypertensive and preeclamptic retinochoroidal pathology, and choroidal blood flow on OCTA could serve as a precursor for disease progression.