Relative Postpartum Retinal Vasoconstriction Detected With Optical Coherence Tomography Angiography

PURPOSE: To characterize changes in retinal perfusion during pregnancy and the postpartum period using optical coherence tomography angiography (OCTA). METHODS: A nonmydriatic OCTA camera was used to image healthy women who were pregnant or in the postpartum period along with nonpregnant controls. Perfusion density (PD) and vessel length density (VLD) in the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) were evaluated. RESULTS: A total of 16, 15, and 13 eyes from nonpregnant, pregnant, and healthy postpartum subjects, respectively, were evaluated. When compared to controls, there were significant increases in ICP PD during the second and third trimester of pregnancy, along with significant decreases in both PD and VLD in SCP, ICP, and DCP up to 14 weeks postpartum. CONCLUSIONS: During pregnancy, vascular changes consistent with retinal vasodilation were noted in the ICP. During the postpartum period, changes in retinal vasculature suggest relative vasoconstriction involving all three layers when compared to both the pregnant and nonpregnant states. TRANSLATIONAL RELEVANCE: Detecting postpartum changes in retinal vasculature could offer important insights into postpartum physiology throughout the body.