The Effect of Hyperemesis Gravidarum on Macular Thickness, Corneal Thickness, and Intraocular Pressure in Pregnancy

Abstract

Aim Physiological changes in intraocular pressure as well as in the cornea and macula may occur during pregnancy. Therefore, we decided to investigate the effect of hyperemesis gravidarum on macular thickness, corneal thickness and intraocular pressure (IOP).

Material and Methods A total of 110 people, 55 of whom were diagnosed with hyperemesis gravidarum and 55 of whom were in the control group, were included in the study. The inclusion criteria for the study were as follows: first trimester (8–14 weeks of gestation) pregnancy with positive fetal heartbeat and no history of systemic disease, no continuous use of medication, diagnosis of hyperemesis gravidarum (ketonuria and weight loss of more than 3 kilograms or 5% of body weight), body mass index (BMI) within normal limits, age between 18 and 40, no alcohol use or smoking.

Results In the HG group compared to the control group, there was a difference between the CCT values of both the right and left eyes (p<0.01). There was a difference in both right and left IOP values in patients in the HG group compared to the control group (p<0.05), and there was no correlation between ketonuria scores and right and left eye CCT values, right and left eye macular thickness, and right and left eye pressure in patients diagnosed with HG (p>0.05).

Conclusion In hyperemesis gravidarum, changes occur in IOP, corneal thickness, and macular thickness. In ophthalmic examinations in the pregestational period, especially for women with systemic disease, it may be important for clinicians to take the necessary precautions in this regard.

Keywords

Corneal thickness - hyperemesis gravidarum - Intraocular pressure - macular thickness

• References

• 1 O’Brien B, Zhou Q. Variables related to nausea and vomiting during pregnancy. Birth 1995; 22: 93-100
• 2 Lacroix R, Eason E, Melzack R. Nausea and vomiting during pregnancy: a prospective study of its frequency, intensity, and patterns of change. Am J Obstet Gynecol 2000; 182: 931-937
• 3 Austin K, Wilson K, Saha S. Hyperemesis gravidarum. Nutrition in Clinical Practice 2019; 34: 226-241
• 4 Verberg MFG, Gillott DJ, Al-Fardan N. et al. Hyperemesis gravidarum, a literature review. Hum Reprod Update 2005; 11: 527-539
• 5 Weinreb RN, Lu A, Beeson C. Maternal corneal thickness during pregnancy. Am J Ophtamol 1988; 105: 258-260
• 6 Park SB, Lindahl KJ, Temnycky GO. et al. The effect of pregnancy on corneal curvature. CLAO J 1992; 18: 256-259
• 7 Qureshi IA. Measurements of intraocular pressure throughout the pregnancy in Pakistani women. Chin Mod Sci J 1997; 12: 53-56
• 8 Ulusoy DM, Duru N, Ataş M. et al. Measurement of choroidal thickness and macular thickness during and after pregnancy. Int J Ophthalmol 2015; 8: 321-325
• 9 Marcos-Figueiredo P, Marcos-Figueiredo A, Menéres P. et al. Ocular changes during pregnancy. Rev Bras Ginecol Obstet 2018; 40: 32-42
• 10 Naderan M. Ocular changes during pregnancy. J Curr Ophthalmol 2018; 30: 202-210
• 11 Feng J, Zhang S, Li W. et al. Intermittent fasting to the eye: A new dimension involved in physiological and pathological changes. Front Med (Lausanne) 2022; 9: 867624
• 12 Savini G, Barboni P, Carbonelli M. et al. Repeatability of automatic measurements by a new Scheimpflug camera combined with Placido topography. J Cataract Refract Surg 2011; 37: 1809-1816
• 13 Ho J, Sull AC, Vuong LN. et al. Assessment of artifacts and reproducibility across spectral and time-domain optical coherence tomography devices. Ophthalmology 2009; 116: 1960-1970
• 14 Erick M. Gestational malnutrition, hyperemesis gravidarum, and Wernicke’s encephalopathy: What is missing?. Nutr Clin Pract 2022; 37: 1273-1290
• 15 Oudman E, Wijnia JW, Oey M. et al. Wernicke’s encephalopathy in hyperemesis gravidarum: A systematic review. Eur J Obstet Gynecol Reprod Biol 2019; 236: 84-93
• 16 Moss HE. Neuro-ophthalmology and pregnancy. Continuum (Minneap Minn) 2022; 28: 147-161