Changes in retinal flow density during and after pregnancy-an optical coherence tomography angiography study

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Recent research indicates retinal vascular changes in pregnant women using optical coherence tomography angiography (OCTA).
• Longitudinal data and reversibility of these retinal OCTA metrics during and after pregnancy are not well-documented.
• This study addresses the gap in understanding the natural evolution of retinal microvasculature throughout pregnancy.

Purpose of the Study:

• To prospectively quantify retinal capillary metrics in healthy pregnant women.
• To describe the natural evolution of OCTA metrics during pregnancy and postpartum.
• To assess the reversibility of pregnancy-associated retinal vascular changes.

Main Methods:

• Prospective study involving 52 eyes of 26 healthy pregnant women.
• Repeated OCTA measurements of superficial (SCP), deep (DCP), choriocapillary (CC), and radial peripapillary (RPC) capillary plexuses.
• Comparison of flow density (FD) and foveal avascular zone (FAZ) parameters prenatally and postnatally using linear mixed models.

Main Results:

• No statistically significant changes in FD or FAZ were observed during the prepartum phase (p > 0.05).
• A significant decrease in FD was noted in the DCP, CC, and RPC capillary plexuses postpartum compared to prepartum (p ≤ 0.04).
• These findings suggest microvascular stability during pregnancy with postpartum adaptations.

Conclusions:

• The retinal microvascular structure remains stable throughout healthy pregnancies.
• Postpartum changes in retinal capillary plexuses suggest late vasculo-structural adaptations after childbirth.
• OCTA is a valuable noninvasive tool for assessing pregnancy-associated microvascular changes.