Hypertension
Poster Session 2
Srilaxmi Bearelly, MD
Associate Professor
Columbia University
Stony Brook, NY, United States
Andrea Perez Moscoso, MD
Columbia University
New York, NY, United States
Lyam Ciccone, MD
Metropolitan, Woodhull Hospital
New York, NY, United States
Hannah R Coleman, MD
Columbia University
New York, NY, United States
Cande V. Ananth, MPH, PhD
Professor and Vice Chair for Academic Affairs, Department of Obstetrics, Gynecology, and Reproductive Sciences
Rutgers Robert Wood Johnson Medical School
New Brunswick, NJ, United States
Ronald J. Wapner, MD (he/him/his)
Professor of OBGYN; Director of Reproductive Genetics
Columbia University Irving Medical Center
New York, NY, United States
Previous publications have suggested a decrease in retinal vascular caliber in preeclampsia (PE) compared with controls. We sought to determine the better measure (retinal vessel caliber or tortuosity) to differentiate between severe PE (sPE) and normotensive controls in the immediate post partum period (≤72 hours).
Study Design:
This cross-sectional study assessed 1) retinal vessel caliber and 2) retinal vascular tortuosity, in the artery and vein, in the superior and inferior temporal vascular arcades respectively. Controls were matched to cases by age, parity and race/ethnicity.
All measurements were made masked to diagnosis, using infrared (IR) images, on the Spectralis camera (Heidelberg Engineering, Germany). Vessel caliber (µm) was measured with the caliper function. Assessments of tortuosity were made using a standardized grading scale that spans from 1 (normal curvature) to 5 (most tortuosity) and were made by a retina specialist (HRC).
Results:
Mean (standard deviation) of gestational age at the time of delivery was 33 (4) weeks in 31 sPE cases and 38 (2) weeks in 35 controls. Retinal arteries measured 96.9 (13.8) μm in PE and 98.9 (14.3) μm in controls (P=0.42). Retinal veins measured 123.7 (16.8) μm in PE and 126.0 (16.1) μm in controls (P=0.62). Artery-to-vein (A:V) ratios did not differ between PE and controls.
The median (range) tortuosity level in the infero-temporal retinal artery was 2 (1-3.5) among sPE cases compared to 1 (1-4) in controls (P=0.04). None of the other vessels differed between cases and controls.
Conclusion:
There was no difference in retinal vessel caliber, or A:V ratios, between subjects with sPE and normotensive controls in the immediate post-partum period. Patients with sPE had more tortuous infero-temporal retinal arteries than normotensive patients (Figure). This may reflect the effect of PE in arteries, compounded by gravitational changes, although the lack of effect in the supero-temporal artery may suggest a small sample size. This supports the use of retinal vascular tortuosity as a potential imaging marker of PE.