Does pregnancy influence eye parameters? Assessment of choroidal thickness using EDI-OCT before and after labour depending on the way of delivery method
, 12, 1, 3, 3, 1, 2
Abstract
Objectives: The aim of this study is to assess the choroidal thickness (CT) with use of EDI-OCT in patients before and after
delivery depending on the mode of delivery.
Material and methods: The study involved 146 eyes of 73 patients aged 20-34 years, after natural labour (66 eyes) and
C-section (80 eyes). Main inclusion criteria: Informed consent to participate in the study, age 18–35 years, single pregnancy,
spherical refraction error –4.00 to +4.00 D, no eye pathologies, no surgery and ophthalmic procedures-including refractive
surgery, childbirth after 36 weeks of pregnancy, BCVA = 1.0. Patients were examined twice: in 36 WG and on 6th week after
the birth. All examinations were carried out between 8:00 am and 10:00 am in order to avoid daily cycle fluctuations. CT
measurements were made manually by two independent researchers at: subfoveal and 500 μm, 1000 μm, 1500 μm, 3000 μm
temporally and nasally. The student’s t-test was made.
Results: In C-section group CT differences before and after delivery were statistically significant in 7/9 of the analysed
areas. Mean subfoveal choroidal thickness was 370.86 μm vs 388.71 μm in 36 WG and in 6th week postpartum respectively
(p = 0.0003). In women after natural labour, differences were statistically significant in 3/9 of the analysed areas. Mean subfoveal
choroidal thickness was 303.27 μm vs 308,34 μm in 36 WG and in 6th week postpartum respectively (p = 0.4800).
Conclusions: The thickness of the choroid was lower in women in 36 WG in comparison to 6th week after birth. Changes
in the thickness of the choroid are particularly noticeable in women after caesarean section.
Keywords: pregnancycaesarean sectionnatural childbirthchoroidoptical coherence tomography
References
- Liu Ru, Kuang GP, Luo DX, et al. Choroidal thickness in pregnant women: a cross-sectional study. Int J Ophthalmol. 2016; 9(8): 1200–1206.
- Spaide RF, Koizumi H, Pozzoni MC, et al. Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol. 2008; 146(4): 496–500.
- Zhang J, Wang H, Yu Q, et al. Enhanced Depth Imaging Optical Coherence Tomography: A New Way Measuring Choroidal Thickness in Pregnant Women. J Ophthalmol. 2017; 2017: 8296574.
- Takahashi J, Kado M, Mizumoto K. Choroidal thickness in pregnant women measured by enhanced depth imaging optical coherence tomography. Jpn J Ophthalmol. 2013; 57: 435.
- Chen W, Li Li, Zhang H, et al. Macular choroidal thickness in highly myopic women during pregnancy and postpartum: a longitudinal study. BMC Pregnancy Childbirth. 2018; 18(1): 220.
- Chakraborty R, Read SA, Collins MJ. Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics. Invest Ophthalmol Vis Sci. 2011; 52(8): 5121–5129.
- Usui S, Ikuno Y, Akiba M, et al. Circadian changes in subfoveal choroidal thickness and the relationship with circulatory factors in healthy subjects. Invest Ophthalmol Vis Sci. 2012; 53(4): 2300–2307.
- Ulaş F, Doğan U, Duran B, et al. Choroidal thickness changes during the menstrual cycle. Curr Eye Res. 2013; 38(11): 1172–1181.
- Wickham LA, Gao J, Toda I, et al. Identification of androgen, estrogen and progesterone receptor mRNAs in the eye. Acta Ophthalmol Scand. 2000; 78(2): 146–153.
- Kur J, Newman EA, Chan-Ling T. Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease. Prog Retin Eye Res. 2012; 31(5): 377–406.
- Ataş M, Duru N, Ulusoy DM, et al. Evaluation of anterior segment parameters during and after pregnancy. Cont Lens Anterior Eye. 2014; 37(6): 447–450.
- Taradaj K, Ginda T, Maciejewicz P, et al. Changes in the parameters of the anterior segment of the eye in pregnant women - literature review. Ginekol Pol. 2018; 89(3): 169–173.
- Tin SS, Wiwanitkit V. Pregnancy and intraocular pressure. Indian J Ophthalmol. 2014; 62(12): 1174.
- Goldich Y, Cooper M, Barkana Y, et al. Ocular anterior segment changes in pregnancy. J Cataract Refract Surg. 2014; 40(11): 1868–1871.
- Sen E, Onaran Y, Nalcacioglu-Yuksekkaya P, et al. Corneal biomechanical parameters during pregnancy. Eur J Ophthalmol. 2014; 24(3): 314–319.
- Tolunay HE, Özcan SC, Şükür YE, et al. Changes of intraocular pressure in different trimesters of pregnancy among Syrian refugees in Turkey: A cross-sectional study. Turk J Obstet Gynecol. 2016; 13(2): 67–70.
- Örnek N, Özcan Dağ Z, Örnek K. Corneal Endothelial Cell Density and Morphology in Different Trimesters of Pregnancy. Eye Contact Lens. 2018; 44 Suppl 1: S125–S130.
- Naderan M, Jahanrad A. Anterior, posterior and biomechanical parameters of cornea during pregnancy in healthy eyes: a cohort study. Br J Ophthalmol. 2018; 102(3): 309–312.
- Carlin A, Alfirevic Z. Physiological changes of pregnancy and monitoring. Best Pract Res Clin Obstet Gynaecol. 2008; 22(5): 801–823.
- Takahashi J, Kado M, Mizumoto K, et al. Changes in Subfoveal Choroidal Thickness During Pregnancy and After Delivery. Ophthalmic Surg Lasers Imaging Retina. 2017; 48(10): 816–821.
- Imamura Y, Fujiwara T, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina. 2009; 29(10): 1469–1473.
- Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy. Retina. 2011; 31(8): 1603–1608.
- Chung SEe, Kang SeW, Lee JH, et al. Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration. Ophthalmology. 2011; 118(5): 840–845.
- Koizumi H, Yamagishi T, Yamazaki T, et al. Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol. 2011; 249(8): 1123–1128.
- Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness after treatment of Vogt-Koyanagi-Harada disease. Retina. 2011; 31(3): 510–517.
- Fong AHC, Li KKW, Wong D. Choroidal evaluation using enhanced depth imaging spectral-domain optical coherence tomography in Vogt-Koyanagi-Harada disease. Retina. 2011; 31(3): 502–509.
- Kara N, Sayin N, Pirhan D, et al. Evaluation of subfoveal choroidal thickness in pregnant women using enhanced depth imaging optical coherence tomography. Curr Eye Res. 2014; 39(6): 642–647.
- Dadaci Z, Alptekin H, Oncel Acir N, et al. Changes in choroidal thickness during pregnancy detected by enhanced depth imaging optical coherence tomography. Br J Ophthalmol. 2015; 99(9): 1255–1259.
- Sayin N, Kara N, Pirhan D, et al. Subfoveal choroidal thickness in preeclampsia: comparison with normal pregnant and nonpregnant women. Semin Ophthalmol. 2014; 29(1): 11–17.
- Goktas S, Basaran A, Sakarya Y, et al. Measurement of choroid thickness in pregnant women using enhanced depth imaging optical coherence tomography. Arq Bras Oftalmol. 2014; 77(3): 148–151.
- Kim JW, Park MH, Kim YJ, et al. Comparison of subfoveal choroidal thickness in healthy pregnancy and pre-eclampsia. Eye (Lond). 2016; 30(3): 349–354.
- Rothwell RT, Meira DM, Oliveira MA, et al. Evaluation of Choroidal Thickness and Volume during the Third Trimester of Pregnancy using Enhanced Depth Imaging Optical Coherence Tomography: A Pilot Study. J Clin Diagn Res. 2015; 9(8): NC08–NC11.
- Ulusoy DM, Duru N, Ataş M, et al. Measurement of choroidal thickness and macular thickness during and after pregnancy. Int J Ophthalmol. 2015; 8(2): 321–325.
- Centofanti M, Migliardi R, Bonini S, et al. Pulsatile ocular blood flow during pregnancy. Eur J Ophthalmol. 2002; 12(4): 276–280.
- Thornburg KL, Jacobson SL, Giraud GD, et al. Hemodynamic changes in pregnancy. Semin Perinatol. 2000; 24(1): 11–14.
- Dahle LO, Andersson RG, Berg G, et al. Alpha-adrenergic receptors in human myometrium: changes during pregnancy. Gynecol Obstet Invest. 1993; 36(2): 75–80.
