RSS-Feed abonnieren

DOI: 10.1055/s-0045-1809911
Evaluation of Maternal Ophthalmic Artery Doppler Velocimetry at 18 to 24 Weeks of Gestational Age in the Prediction of Preeclampsia

Abstract
Background
Preeclampsia (PE) is a crucial health issue that complicates roughly 10% of gestations and causes more than 50,000 deaths yearly worldwide. Most women with PE have mildly high blood pressure, a small amount of excess protein in the urine, and they do not experience any symptoms of the disease. This is the reason that prenatal screening of increased blood pressure is done in later pregnancy period.
Aims and Objectives
The aim of this study was to evaluate the role of maternal ophthalmic artery Doppler velocimetry in predicting PE. The objectives were to examine the velocimetry values in the women undergoing antenatal scan at 18 to 24 weeks of gestation and their potential value in the subsequent development of PE.
Materials and Methods
A prospective observational study was conducted on 800 women who visited the hospital for antenatal ultrasound at 18 to 24 gestational weeks. Ophthalmic artery Doppler study was conducted to obtain the spectral waveform from both eyes after recording the patient history. Doppler indices like first peak systolic velocity (PSV1), second peak systolic velocity (PSV2), pulsatility index (PI), end-diastolic velocity (EDV), resistivity index (RI), systolic/diastolic ratio (S/D), and PSV2 to PSV1 ratio (PSV ratio: PSV2/PSV1) were obtained and their average values were obtained. All patients were then followed up till termination of pregnancy to document the development of PE.
Statistical Analysis
The collected data were entered into the Microsoft Excel and then analyzed and statistically evaluated using SPSS-25 version.
Results
The study revealed that a total 95 subjects developed PE (11.9%) from a total of 800 subjects. The ophthalmic artery PSV2/PSV1 ratio and PSV2 of right and left eye were significantly increased in patients with PE. The EDV in pre-eclamptic patients was also increased as compared to normotensive patients. The average values of the PI and RI were decreased in PE patients as compared to normotensive patients. The S/D ratio was also decreased in patients who later developed PE as compared to normotensive patients.
Conclusion
Ophthalmic artery Doppler velocimetry can detect PE in early stages and is a cheap, noninvasive, readily available, safe, and reliable tool for evaluation of hemodynamic changes in normotensive pregnancy, and even more so in PE. The most reliable parameters being the PSV2 and PSV2/PSV1 ratio with sensitivity of both the parameters being more than 90%. The other parameters like increased EDV and decreased PI and RI also have some role.
Publikationsverlauf
Artikel online veröffentlicht:
10. Juli 2025
© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Brown MA, Magee LA, Kenny LC. et al; International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension 2018; 72 (01) 24-43
- 2 Tranquilli AL, Dekker G, Magee L. et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens 2014; 4 (02) 97-104
- 3 WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. Geneva: WHO; 2011. ISBN 978-92-4-154833-5
- 4 Mackensen F, Paulus WE, Max R, Ness T. Ocular changes during pregnancy. Dtsch Arztebl Int 2014; 111 (33–34): 567-575 , quiz 576
- 5 Kane SC, Brennecke SP, da Silva Costa F. Ophthalmic artery Doppler analysis: a window into the cerebrovasculature of women with pre-eclampsia. Ultrasound Obstet Gynecol 2017; 49 (01) 15-21
- 6 Nicolaides KH, Sarno M, Wright A. Ophthalmic artery Doppler in the prediction of preeclampsia. Am J Obstet Gynecol 2022; 226 (2S): S1098-S1101
- 7 Sapantzoglou I, Wright A, Arozena MG, Campos RV, Charakida M, Nicolaides KH. Ophthalmic artery Doppler in combination with other biomarkers in prediction of pre-eclampsia at 19-23 weeks' gestation. Ultrasound Obstet Gynecol 2021; 57 (01) 75-83
- 8 Selima ER, Abar AM, Dessouky BA. Role of ophthalmic artery Doppler in prediction of preeclampsia. Egypt J Hosp Med 2022; 87 (01) 1944-1952
- 9 Naemi M, Saleh M, Saleh M. Ophthalmic artery Doppler indices changes in preeclampsia. J Obstet Gynecol Cancer Res 2023; 8 (02) 125-130
- 10 Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013; 122 (05) 1122-1131
- 11 De Paco C, Kametas N, Rencoret G, Strobl I, Nicolaides KH. Maternal cardiac output between 11 and 13 weeks of gestation in the prediction of preeclampsia and small for gestational age. Obstet Gynecol 2008; 111 (2, Pt 1): 292-300
- 12 Stott D, Nzelu O, Nicolaides KH, Kametas NA. Maternal hemodynamics in normal pregnancy and in pregnancy affected by pre-eclampsia. Ultrasound Obstet Gynecol 2018; 52 (03) 359-364
- 13 Bird B, Stawicki SP. Anatomy, Head and Neck, Ophthalmic Arteries. Treasure Island, FL: StatPearls Publishing; 2022
- 14 Matias DS, Costa RF, Matias BS, Gordiano L, Correia LC. Predictive value of ophthalmic artery Doppler velocimetry in relation to development of pre-eclampsia. Ultrasound Obstet Gynecol 2014; 44 (04) 419-426
- 15 Praciano de Souza PC, Gurgel Alves JA, Bezerra Maia E Holanda Moura S, Araujo Júnior E, Martins WP, Da Silva Costa F. Second trimester screening of preeclampsia using maternal characteristics and uterine and ophthalmic artery Doppler. Ultraschall Med 2018; 39 (02) 190-197
- 16 de Melo PFMV, Roever L, Mendonça TMS, da Silva Costa F, Rolnik DL, Diniz ALD. Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2023; 23 (01) 343
- 17 Mansukhani T, Wright A, Arechvo A. et al. Maternal vascular indices at 36 weeks' gestation in the prediction of preeclampsia. Am J Obstet Gynecol 2024; 230 (04) 448.e1-448.e15
- 18 Sarno M, Wright A, Vieira N, Sapantzoglou I, Charakida M, Nicolaides KH. Ophthalmic artery Doppler in combination with other biomarkers in prediction of pre-eclampsia at 35-37 weeks' gestation. Ultrasound Obstet Gynecol 2021; 57 (04) 600-606 ( Erratum in: Ultrasound Obstet Gynecol. 2022 Mar;59(3):407. doi: 10.1002/uog.24878. PMID: 33073902)
- 19 Gyokova E, Hristova-Atanasova E, Iskrov G. Preeclampsia management and maternal ophthalmic artery Doppler measurements between 19 and 23 weeks of gestation. J Clin Med 2024; 13 (04) 950 –0