Ocular perfusion pressure and intraocular pressure in pregnant women with severe preeclampsia
Abstract
Objectives: The aim of this study was to investigate whether severe preeclampsia (SPE) affects intraocular pressure (IOP) and ocular perfusion pressure (OPP).
Material and methods: This prospective and comparative study included 64 pregnant females, allocated into 2 groups as Group 1 (31 pregnant women with SPE) and Group 2 (33 normotensive pregnant women). IOP, systolic and diastolic blood pressure, OPP of all the subjects were measured after 20 weeks of gestation and prior to labor and medical therapy.
Results: The mean IOP values in Group 1 were not significantly different from those of Group 2 (p = 0.528). The mean OPP values in Group 1 were significantly higher than those of Group 2 (p < 0.001). There was no significant correlation between IOP and OPP levels. No significant differences were determined between the groups in respect of age, gestational age body mass index (BMI) (p < 0.269, p < 0.219 and p < 0.556 respectively). The mean systolic and diastolic blood pressure values were statistically significantly higher in Group 1 than in Group 2 (p < 0.001 and p < 0.001).
Conclusions: Although high IOP was expected in SPE patients, it was found to be constant. This could have been due to an increase in aqueous humor outflow because of changes occurring in angiogenic and anti-angiogenic factors in SPE.
Keywords: severe preeclampsiaintraocular pressureocular perfusion pressure
References
- Mol B, Roberts C, Thangaratinam S, et al. Pre-eclampsia. The Lancet. 2016; 387(10022): 999–1011.
- Hypertension in Pregnancy. Obstetrics & Gynecology. 2013; 122(5): 1122–1131.
- Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. BJOG: An International Journal of Obstetrics & Gynaecology. 2011; 118: 1–203.
- Sibai B. Evaluation and management of severe preeclampsia before 34 weeks' gestation. American Journal of Obstetrics and Gynecology. 2011; 205(3): 191–198.
- C.Weel I, Romão-Veiga M, Matias M, et al. Increased expression of NLRP3 inflammasome in placentas from pregnant women with severe preeclampsia. Journal of Reproductive Immunology. 2017; 123: 40–47.
- Prado R, Figueiredo E, Magalhães T. Retinal Detachment in Preeclampsia. Arquivos Brasileiros de Cardiologia. 2002; 79(2): 185–186.
- Murphy M, Casselman R, Smith G. Postpartum alterations in circulating endothelial progenitor cells in women with a history of pre-eclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2013; 3(3): 178–185.
- Kvehaugen AS, Dechend R, Ramstad HB, et al. Endothelial Function and Circulating Biomarkers Are Disturbed in Women and Children After Preeclampsia. Hypertension. 2011; 58(1): 63–69.
- Lupton SJ, Chiu CL, Hodgson L, et al. Changes in Retinal Microvascular Caliber Precede the Clinical Onset of Preeclampsia. Hypertension. 2013; 62(5): 899–904.
- Qureshi I, Xi X, Wu X. Intraocular pressure trends in pregnancy and in the third trimester hypertensive patients. Acta Obstetricia et Gynecologica Scandinavica. 1996; 75(9): 816–819.
- Goel M. Aqueous Humor Dynamics: A Review~!2010-03-03~!2010-06-17~!2010-09-02~! The Open Ophthalmology Journal. 2010; 4(1): 52–59.
- Barbosa C, Stefanini F, Penha F, et al. Intraocular pressure and ocular perfusion during hemodialysis. Arquivos Brasileiros de Oftalmologia. 2011; 74(2): 106–109.
- Garg A, Wapner R, Ananth C, et al. Choroidal and Retinal Thickening in Severe Preeclampsia. Investigative Opthalmology & Visual Science. 2014; 55(9): 5723.
- Levine R, Maynard S, Qian C, et al. Circulating Angiogenic Factors and the Risk of Preeclampsia. New England Journal of Medicine. 2004; 350(7): 672–683.
- Sunness J. The pregnant woman's eye. Survey of Ophthalmology. 1988; 32(4): 219–238.
- Changes in intraocular pressure and central corneal thickness during pregnancy: a systematic review and Meta-analysis. International Journal of Ophthalmology. 2017.
- WEINREB R, LU A, KEY T. Maternal Ocular Adaptations during Pregnancy. Obstetrical & Gynecological Survey. 1987; 42(8): 471–483.
- Green K, Phillips C, Cheeks L, et al. Aqueous Humor Flow Rate and Intraocular Pressure during and after Pregnancy. Ophthalmic Research. 1988; 20(6): 353–357.
- Wilke K. Episcleral venous pressure and pregnancy. Acta Ophthalmologica. 2009; 53(S125): 40–41.
- Dinn R, Harris A, Marcus P. Ocular Changes in Pregnancy. Obstetrical & Gynecological Survey. 2003; 58(2): 137–144.
- Qureshi IA. Intraocular pressure and pregnancy: a comparison between normal and ocular hypertensive subjects. Arch Med Res. 1997; 28(3): 397–400.
- Giannina G, Belfort M, Abadejos P, et al. Comparison of intraocular pressure between normotensive and preeclamptic women in the peripartum period. American Journal of Obstetrics and Gynecology. 1997; 176(5): 1052–1055.
- Phillips CI, Gore SM. Ocular hypotensive effect of late pregnancy with and without high blood pressure. British Journal of Ophthalmology. 1985; 69(2): 117–119.
- Sayin N, Kara N, Pirhan D, et al. Subfoveal Choroidal Thickness in Preeclampsia: Comparison with Normal Pregnant and Nonpregnant Women. Seminars in Ophthalmology. 2013; 29(1): 11–17.
- LESKE M, PODGOR M. INTRAOCULAR PRESSURE, CARDIOVASCULAR RISK VARIABLES, AND VISUAL FIELD DEFECTS. American Journal of Epidemiology. 1983; 118(2): 280–287.
- Bill A. The role of ciliary blood flow and ultrafiltration in aqueous humor formation. Experimental Eye Research. 1973; 16(4): 287–298.
- Klein B. Intraocular pressure and systemic blood pressure: longitudinal perspective: the Beaver Dam Eye Study. British Journal of Ophthalmology. 2005; 89(3): 284–287.
- Bill A. Blood circulation and fluid dynamics in the eye. Physiological Reviews. 1975; 55(3): 383–417.
- Physiology of the Eye: Clinical Application. Journal of the American Medical Association. 1960; 172(12): 1340.
- HALLUM A. EYE CHANGES IN HYPERTENSIVE TOXEMIA OF PREGNANCY. Journal of the American Medical Association. 1936; 106(19): 1649.
- OHNO Y, KAWAI M, WAKAHARA Y, et al. Ophthalmic Artery Velocimetry in Normotensive and Preeclamptic Women With or Without Photophobia. Obstetrics & Gynecology. 1999; 94(3): 361–363.
