Subscribe to RSS
DOI: 10.1055/a-2371-1856
Evaluation of Ophthalmic Artery Doppler Parameters in Preeclamptic and Normotensive Pregnant Women

Abstract
Objective Preeclampsia, whose pathophysiology is still not fully elucidated today, is a pregnancy-specific disease that affects most organ systems in pregnant women, including the central nervous system. In this context, we aimed to investigate the effects of preeclampsia on blood flow in the ophthalmic artery of the eye, which is considered a part of the central nervous system.
Materials and Methods This prospective, non-interventional cohort study was conducted between February 2022 and June 2022 at Umraniye Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey. Forty-six normotensive healthy pregnant women constituted the control group and 46 preeclamptic pregnant women constituted the preeclampsia group. Prenatal follow-up and delivery of the participants were carried out in our clinic. First, an obstetric ultrasound was performed on all participants with the same ultrasound device and the same clinician. Then, Doppler measurements of the ophthalmic artery of both eyes were made by the same clinician using the linear probe of the same ultrasound. Both groups were compared in terms of the first peak of systolic velocity (PSV), second PSV, pulsatility index (PI), PSV ratio, end-diastolic velocity (EDV), resistance index (RI), and systolic/diastolic ratio (S/D) measurements of the ophthalmic artery.
Results The first PSV, second PSV, PSV ratio, and EDV were significantly higher in the preeclampsia group than in the control group (p=0.001, p<0.001, p=0.019, p<0.001, respectively). According to the receiver operating characteristic analysis, the second PSV with a cut-off value of 43.75 cm/s was the most powerful ophthalmic artery Doppler parameter in detecting preeclampsia with 63% sensitivity and 63% specificity. No significant difference was found between the early and late onset or mild and severe preeclampsia groups in terms of ophthalmic artery Doppler parameters.
Conclusion Although the number of participants was too small to draw a definitive conclusion, the second PSV seems to be the most powerful parameter for the detection of preeclampsia. Studies with larger series are needed to determine the usability of ophthalmic artery Doppler parameters in the routine clinical diagnosis of preeclampsia and follow-up of the disease.
Publication History
Received: 02 May 2024
Accepted after revision: 09 July 2024
Article published online:
19 August 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Eiland E, Nzerue C, Faulkner M. Preeclampsia 2012. J Pregnancy 2012; 2012: 1-7
- 2 Dimitriadis E, Rolnik DL, Zhou W. et al. Pre-eclampsia. Nat Rev Dis Primer 2023; 9: 8
- 3 Erez O, Romero R, Jung E. et al. Preeclampsia and eclampsia: the conceptual evolution of a syndrome. Am J Obstet Gynecol 2022; 226: S786-S803
- 4 Miller EC, Vollbracht S. Neurology of Preeclampsia and related disorders: an update in neuro-obstetrics. Curr Pain Headache Rep 2021; 25: 40
- 5 Duley L. The global ımpact of pre-eclampsia and eclampsia. Semin Perinatol 2009; 33: 130-137
- 6 Çalım M, Daşkaya H, İnal F. et al. Posteriyor Reversibl Ensefalopati Sendromu (PRES) ve Hayat Kurtarıcı Yoğun Bakım Ünitesi. Anadolu Klin Tıp Bilim Derg 2017; 22: 46-46
- 7 J Spaan J, A Brown M Renin-angiotensin system in pre-eclampsia: everything old is new again. Obstet Med Med Pregnancy 2012; 5: 147-153
- 8 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: 15-21
- 9 Matthiessen ET, Zeitz O, Richard G. et al. Reproducibility of blood flow velocity measurements using colour decoded Doppler imaging. Eye 2004; 18: 400-405
- 10 De Oliveira CA, De Sá RAM, Velarde LGC. et al. Doppler velocimetry of the ophthalmic artery: Reproducibility of blood flow velocity measurements. J Ultrasound Med 2012; 31: 879-884
- 11 Alves Borges JH, Goes DA, De Araújo LB. et al. Prospective study of the hemodynamic behavior of ophthalmic arteries in postpartum preeclamptic women: A doppler evaluation. Hypertens Pregnancy 2016; 35: 100-111
- 12 Ozdemir ME, Demirci O, Ozturkmen HA. et al. What ıs the role of the maternal ophthalmic and cervical ınternal carotid arteries in predicting maternal adverse outcomes in preeclampsia?. J Ultrasound Med 2020; 39: 1527-1535
- 13 Diniz ALD, Menêses VFSDC, Freitas MARD. et al. Performance of ophthalmic artery Doppler velocimetry in the complementary diagnosis of preeclampsia. J Matern Fetal Neonatal Med 2024; 35: 9078-9085
- 14 Madina SR, Bacha R, Gilani SA. et al. Comparison of the resistive indices obtained in the uterine artery and the ophthalmic artery in preeclamptic and normotensive patients in Doppler US. J Ultrason 2020; 20: e95-e99
- 15 Belfort MA, Saade GR, Grunewald C. et al. Effects of blood pressure on orbital and middle cerebral artery resistances in healthy pregnant women and women with preeclampsia. Am J Obstet Gynecol 1999; 180: 601-607
- 16 De Melo PFMV, Roever L, Mendonça TMS. et al. Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2023; 23: 343
- 17 Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222. Obstet Gynecol 2020; 135: 1492-1495
- 18 Erickson SJ, Hendrix LE, Massaro BM. et al. Color Doppler flow imaging of the normal and abnormal orbit. Radiology 1989; 173: 511-516
- 19 Sapantzoglou I, Wright A, Arozena MG. et al. Ophthalmic artery Doppler in combination with other biomarkers in prediction of pre-eclampsia at 19–23 weeks’ gestation. Ultrasound Obstet Gynecol 2021; 57: 75-83
- 20 Hata T, Senoh D, Hata K. et al. Ophthalmic artery velocimetry in pregnant women. Lancet 1992; 340: 182-183
- 21 Hata T, Hata K, Moritake K. Maternal ophthalmic artery Doppler velocimetry in normotensive pregnancies and pregnancies complicated by hypertensive disorders. Am J Obstet Gynecol 1997; 177: 174-178
- 22 Saleh M, Naemi M, Aghajanian S. et al. Diagnostic value of ophthalmic artery Doppler indices for prediction of preeclampsia at 28–32 weeks of gestation. Int J Gynecol Obstet 2023; 160: 120-130
- 23 Ayaz T, Akansel G, Hayirlioglu A. et al. Ophthalmic artery color Doppler ultrasonography in mild-to-moderate preeclampsia. Eur J Radiol 2003; 46: 244-249
- 24 Adekanmi A, Olatunji R, Obajimi M. et al. Maternal ophthalmic artery Doppler velocimetry in pre-eclampsia in Southwestern Nigeria. Int J Womens Health 2015; 723
- 25 Kalafat E, Laoreti A, Khalil A. et al. Ophthalmic artery Doppler for prediction of pre-eclampsia: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2018; 51: 731-737