Retinal imaging in pre-eclamptic pregnancy: systematic review.

Area of Science:

• Ophthalmology
• Maternal-Fetal Medicine
• Cardiovascular Medicine

Background:

• Pre-eclampsia (PE) is a serious pregnancy complication characterized by hypertension and potential organ damage.
• Retinal structure and function may be affected by PE, but findings are inconsistent.
• Understanding these changes is crucial for early detection and management of PE.

Purpose of the Study:

• To systematically review existing literature on retinal structural and functional changes in pregnancies complicated by pre-eclampsia (PE).
• To synthesize findings from various retinal imaging techniques used in PE research.
• To identify gaps in current knowledge and suggest future research directions.

Main Methods:

• A systematic literature review was conducted using PubMed, EMBASE, The Cochrane Library, and Scopus.
• Studies included randomized controlled trials, cohort, case-control, and population-based studies examining the retina in women with PE.
• Risk of bias was assessed using the ROBINS-I V2 tool; meta-analysis was not performed due to heterogeneity.

Main Results:

• Twenty-four studies were included, utilizing optical coherence tomography (OCT), OCT angiography (OCTA), retinal fundus photography, and Doppler ultrasound.
• OCT studies showed inconsistent findings in choroidal thickness and retinal thickness parameters.
• OCTA, fundus photography, and Doppler studies also reported varied results regarding vascular changes and blood flow in women with PE.
• Most studies indicated a moderate to serious risk of bias.

Conclusions:

• Current evidence on retinal structural and functional changes in pre-eclampsia is inconclusive.
• The timing and causality of these retinal changes in relation to PE onset and hypertension are uncertain.
• There is a significant need for large-scale, prospective studies to clarify the role of retinal assessment in PE.