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. 2023 May 18;18(5):e0285884.
doi: 10.1371/journal.pone.0285884. eCollection 2023.

Diminished choroidal blood flow in hypertensive and preeclamptic third trimester pregnancies using optical coherence tomography angiography

Alaa E Fayed  1   2 , Mohamed M Thabet  3 , Marwa Metwally Salama  1 , Malak El Shazly  1
Affiliations

Diminished choroidal blood flow in hypertensive and preeclamptic third trimester pregnancies using optical coherence tomography angiography

Alaa E Fayed et al. PLoS One. .

Abstract

Purpose: The aim of this study was to compare choroidal adjusted flow index (AFI) in healthy, hypertensive & preeclamptic pregnancies using optical coherence tomography angiography (OCTA).

Methods: In this prospective study, healthy, hypertensive & preeclamptic third trimester pregnant women underwent OCTA imaging. 3x3 & 6x6 mm choriocapillaris slabs were exported and the parafoveal area was marked by two concentric ETDRS circles at 1 & 3 mm, centered on the foveal avascular zone. Parafoveal AFI was calculated as a parameter of choroidal blood flow.

Results: Fifteen eyes of fifteen women per group were recruited (45 eyes). AFI was significantly lower in the preeclamptic compared to the healthy & hypertensive groups (Tukey HSD: <0.001 in both groups on 3x3 mm, and 0.02 & 0.04 in 6x6 mm scans), and in the hypertensive compared to the healthy group (0.005 & 0.03 in 3x3 & 6x6 mm scans respectively).

Conclusions: Pregnancies complicated with preeclampsia revealed the lowest choroidal blood flow on OCTA followed by pregnancies with systemic hypertension compared to healthy pregnancies. We provide in-vivo documentation of choroidal ischemia, highlighting its culpability in hypertensive and preeclamptic retinochoroidal pathology, and the possibility of utilizing choroidal blood flow on OCTA as a precursor for disease progression.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Parafoveal adjusted flow index calculation.
(A) 6x6 mm2 full retinal thickness OCTA slab with a yellow circle delineating the foveal avascular zone used to establish the noise threshold. (B) Choriocapillaris OCTA slab fitted with1- & 3-mm circles centered on the FAZ to outline the parafovea. (C) Binarized vessels of the choriocapillaris parafovea with elimination of pixels below the threshold. Average pixel intensity above the threshold was used to calculate adjusted flow index (AFI).
Fig 2
Fig 2. Parafoveal adjusted flow index calculated in 3x3 mm scans of 3 eyes from each of the study groups.
See this image and copyright information in PMC

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