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Retinal imaging in pre-eclamptic pregnancy: systematic review.

D Kitmiridou1,2, I Mitrogiannis1, M Charakida1,3

  • 1Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK.

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
|January 14, 2026
PubMed
Summary

Research on retinal changes in pre-eclampsia (PE) is inconclusive. Studies using optical coherence tomography and other methods found varied results, highlighting the need for larger prospective studies to understand these retinal alterations in pregnancy.

Keywords:
central retinal artery Dopplerchoroidal thicknessoptical coherence tomographyoptical coherence tomography angiographypregnancypre‐eclampsiaretinal fundus photographyretinal imaging

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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.