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Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia

PURPOSE: Pre-eclampsia (PE) is a serious complication of pregnancy characterized by high blood pressure, proteinuria, compromised fetal blood supply, and potential organ damage. The superficial location of the eye makes it an ideal target for characterization hemodynamics. Our aim was to discern the...

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Autores principales: Silverman, Ronald H., Urs, Raksha, Wapner, Ronald J., Bearelly, Srilaxmi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Association for Research in Vision and Ophthalmology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490228/
https://www.ncbi.nlm.nih.gov/pubmed/32974086
http://dx.doi.org/10.1167/tvst.9.10.14
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author Silverman, Ronald H.
Urs, Raksha
Wapner, Ronald J.
Bearelly, Srilaxmi
author_facet Silverman, Ronald H.
Urs, Raksha
Wapner, Ronald J.
Bearelly, Srilaxmi
author_sort Silverman, Ronald H.
collection PubMed
description PURPOSE: Pre-eclampsia (PE) is a serious complication of pregnancy characterized by high blood pressure, proteinuria, compromised fetal blood supply, and potential organ damage. The superficial location of the eye makes it an ideal target for characterization hemodynamics. Our aim was to discern the impact of PE on ocular blood flow. METHODS: 18 MHz plane-wave ophthalmic ultrasound scanning was performed on subjects with PE (n = 26), chronic or gestational hypertension (n = 8), and normal controls (n = 19) within 72 hours of delivery. Duplicate three-second long scans of the posterior pole including the optic nerve were acquired at 6000 images/sec for evaluation of the central retinal artery and vein and the short posterior ciliary arteries. The choroid was scanned at 1000 images/sec. Doppler analysis provided values of pulsatile flow velocity and resistance indexes. RESULTS: End diastolic velocity was higher, and pulsatility and resistive indexes were significantly lower in the choroid, central retinal artery and short posterior ciliary arteries in PE than in controls. Blood pressure was elevated in PE with respect to controls and was negatively correlated with resistance. CONCLUSIONS: Although vasoconstriction is considered characteristic of PE, we found reduced resistance in the orbital vessels and choroidal arterioles, implying vasodilation at this level. Future studies incorporating optical coherence tomography angiography for characterization of the retina and choriocapillaris in conjunction with plane-wave ultrasound scanning, particularly in late pregnancy, might address this conundrum. TRANSLATIONAL RELEVANCE: Use of plane-wave ultrasound scanning for evaluation ocular blood flow in women at risk for PE may offer an avenue towards early detection and clinical intervention.
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spelling pubmed-74902282020-09-23 Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia Silverman, Ronald H. Urs, Raksha Wapner, Ronald J. Bearelly, Srilaxmi Transl Vis Sci Technol Article PURPOSE: Pre-eclampsia (PE) is a serious complication of pregnancy characterized by high blood pressure, proteinuria, compromised fetal blood supply, and potential organ damage. The superficial location of the eye makes it an ideal target for characterization hemodynamics. Our aim was to discern the impact of PE on ocular blood flow. METHODS: 18 MHz plane-wave ophthalmic ultrasound scanning was performed on subjects with PE (n = 26), chronic or gestational hypertension (n = 8), and normal controls (n = 19) within 72 hours of delivery. Duplicate three-second long scans of the posterior pole including the optic nerve were acquired at 6000 images/sec for evaluation of the central retinal artery and vein and the short posterior ciliary arteries. The choroid was scanned at 1000 images/sec. Doppler analysis provided values of pulsatile flow velocity and resistance indexes. RESULTS: End diastolic velocity was higher, and pulsatility and resistive indexes were significantly lower in the choroid, central retinal artery and short posterior ciliary arteries in PE than in controls. Blood pressure was elevated in PE with respect to controls and was negatively correlated with resistance. CONCLUSIONS: Although vasoconstriction is considered characteristic of PE, we found reduced resistance in the orbital vessels and choroidal arterioles, implying vasodilation at this level. Future studies incorporating optical coherence tomography angiography for characterization of the retina and choriocapillaris in conjunction with plane-wave ultrasound scanning, particularly in late pregnancy, might address this conundrum. TRANSLATIONAL RELEVANCE: Use of plane-wave ultrasound scanning for evaluation ocular blood flow in women at risk for PE may offer an avenue towards early detection and clinical intervention. The Association for Research in Vision and Ophthalmology 2020-09-14 /pmc/articles/PMC7490228/ /pubmed/32974086 http://dx.doi.org/10.1167/tvst.9.10.14 Text en Copyright 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Article
Silverman, Ronald H.
Urs, Raksha
Wapner, Ronald J.
Bearelly, Srilaxmi
Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia
title Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia
title_full Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia
title_fullStr Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia
title_full_unstemmed Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia
title_short Plane-Wave Ultrasound Doppler of the Eye in Preeclampsia
title_sort plane-wave ultrasound doppler of the eye in preeclampsia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490228/
https://www.ncbi.nlm.nih.gov/pubmed/32974086
http://dx.doi.org/10.1167/tvst.9.10.14
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