Choroidal changes in pre-eclampsia during pregnancy and the postpartum period: comparison with healthy pregnancy.

PURPOSE: To investigate subfoveal choroidal thickness (SFCT) in patients with pre-eclampsia using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: A sample of 73 pregnant women was studied over 28 weeks of gestation. The sample was divided into two groups: one comprising pre-eclamptic pregnant women (n=32), and the other comprising healthy pregnant women (n=41). The SFCT was determined for all patients using EDI-OCT during pregnancy and at the third month of the postpartum period. RESULTS: The SFCTs in pre-eclamptic pregnant women were 351.97 ± 22.44 and 332.28 ± 20.32 µm during the pregnancy and postpartum periods (p<0.001), respectively, whereas these values in healthy pregnant women were 389.73 ± 49.64 and 329.78 ± 22.36 µm (p<0.001), respectively. During pregnancy SFCT in pre-eclamptic pregnant women was significantly thinner than that in healthy pregnant women (p<0.001). However, there was no statistically significant difference during the postpartum period (p=0.623). CONCLUSIONS: The results suggest that SFCT is significantly decreased in pre-eclamptic pregnant women than in healthy pregnant women, despite no statistically significant difference in SFCT existing between the groups during the postpartum period.

Assessment of Macular Peripapillary Nerve Fiber Layer and Choroidal Thickness Changes in Pregnant Women with Gestational Diabetes Mellitus, Healthy Pregnant Women, and Healthy Non-Pregnant Women.

BACKGROUND: Gestational diabetes mellitus (GDM) is a risk factor for the development of type II diabetes and it causes maternal and child morbidity. Screening for diabetic retinopathy (DR) is important because patients who develop DR have no symptoms until macular edema and/or proliferative diabetic retinopathy (PDR) are already present. The aim of this study was to determine the early retinal findings of GDM. MATERIAL AND METHODS: This study was conducted in a tertiary research center. We conducted a prospective cross-sectional study with 3 groups: Group 1 consisted of 36 pregnant women with GDM, Group 2 consisted of 24 healthy pregnant women, and Group 3 consisted of 38 healthy non-pregnant women of reproductive age. Spectralis optical coherence tomography (OCT) was used for the assessment. Macular, choroid, and retinal nerve fiber layer (RNFL) thicknesses were evaluated in patients with GDM and comparisons were made among pregnant women with GDM, healthy pregnant women, and healthy non-pregnant women for these parameters. RESULTS: The nasal part of the RNFL was significantly thinner in the GDM group than in the healthy pregnant group. None of the patients had retinopathy or macular edema at the time of examination. CONCLUSIONS: Decreased nasal part of RNFL thickness may be the first retinal change in patients with GDM. Our study suggests that OCT should be performed for the patients with GDM for detection of early retinal changes associated with GDM.

Evaluation of anterior segment parameters during and after pregnancy.

PURPOSE: To compare the anterior segment parameters during pregnancy and post-pregnancy. MATERIALS AND METHODS: Fifty-four healthy pregnant women in their third trimester with ages ranging from 18 to 38 years were included in the study. All of the patients underwent comprehensive ophthalmologic examinations, including refraction, anterior segment, and fundus examinations, intraocular pressure, and axial length measurements. In addition, anterior chamber angle, anterior chamber depth, anterior chamber volume, corneal volume, central corneal thickness, and keratometry values were measured by Pentacam Scheimpflug camera. All measurements were measured again 3 months after delivery. RESULTS: The mean intraocular pressure, anterior chamber angle, anterior chamber depth, anterior chamber volume, corneal volume, central corneal thickness, and keratometry measurements were significantly different during pregnancy and post-pregnancy (p<0.05 for all); however, the mean spherical refraction, cylindrical refraction, and axial length were not statistically significantly different during pregnancy and post-pregnancy (p>0.05 for all). CONCLUSIONS: We found that there is an increase in the anterior chamber parameters, corneal volume, corneal thickness, and corneal curvature and a decrease in intraocular pressure in the third trimester.

Evaluation of the Macula, Retinal Nerve Fiber Layer, and Choroid Thickness in Women With Polycystic Ovary Syndrome Using Spectral-Domain Optical Coherence Tomography.

This study aimed to investigate the macular, retinal nerve fiber layer (RNFL), and choroid thickness alterations using spectral-domain optical coherence tomography in women with polycystic ovary syndrome (PCOS) and to compare them with healthy reproductive-age women volunteers. Study group consisted of 64 patients with PCOS and control group consisted of 60 healthy volunteers. There was a statistically significant difference between PCOS and control groups for choroid thickness (P < .001). Fovea center thickness and temporal inner macula were significantly thinner in the PCOS group than those in the healthy control group (P = .009 and P = .033, respectively). Contrary to these findings, nasal outer macula (NOM) and temporal outer macula (TOM) were statistically thicker in the PCOS group than those in the control group (P = .001 and P < .001, respectively). Increased choroid thickness and RNFL may lead to increase in both retinal volume and retinal thickness in the peripheral side of the retina. Therefore, NOM and TOM region can be accepted sensitive areas in patients with PCOS.

Evaluation of the macula, retinal nerve fiber layer and choroid in preeclampsia, healthy pregnant and healthy non-pregnant women using spectral-domain optical coherence tomography.

OBJECTIVE: To evaluate the macular, retinal nerve fiber layer (RNFL) and choroidal thickness alterations by using spectral-domain optical coherence tomography (SD-OCT) in preeclampsia and compare with healthy pregnant and healthy non-pregnant controls. METHOD: The study population included healthy pregnant control group (n: 25), healthy non-pregnant control group (n: 26) and study group with preeclampsia (n: 27). Retinal thickness parameters were measured by SD-OCT. RESULTS: There was a statistically significant difference among all of the groups for choroidal thickness (p < 0.001). Choroidal thickness in preeclamptic women was significantly thinner than healthy pregnant women. The most thick choroid layer was detected in healthy pregnant group, and also the most thin choroidal thickness was detected in healthy non-pregnant group (p < 0.001). Macular central subfield and foveal center thickness were significantly thinner in preeclamptic study and healthy pregnant groups than healthy non-pregnant group (p < 0.001). However, there was no statistically significant difference between preeclamptic study group and healthy pregnant group for both macular central subfield and foveal center thickness. Average of RNFL thickness was significantly thicker in healthy pregnant group than healthy non-pregnant group (p = 0.004). CONCLUSIONS: This study revealed that choroidal thickness measured using SD-OCT increased in women with preeclampsia and healthy pregnant women but the increase in choroidal thickness in preeclampsia was lower than the healthy pregnant controls. This lower rise in choroidal thickness can be generally attributed to the markedly increased systemic vascular vasospasm secondary to preeclampsia.