Assessing retinal microvasculature as a biomarker for systemic vascular dysfunction in preeclampsia: A case-control study

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Introduction Preeclampsia (PE) complicates up to 10% of pregnancies worldwide. Foetal and maternal deaths associated with preeclampsia are highest in women who are of Hispanic and African descent. Retinal arterial narrowing has been strongly associated with hypertension. Retinal imaging provides a novel method to non-invasively assess the microvasculature and explore its association with systemic vasculature in preeclampsia. Methods This case-control study was carried out at Frere and Nelson Mandela Academic Hospitals, Eastern Cape, South Africa. It involved the recruitment of 108 pregnant women (49 preeclamptic women and 59 normotensive). Anthropometry was measured, followed by blood pressure. Carotid-femoral pulse wave velocity (cfPWV), ankle-brachial index (ABI), and retinal vessel calibres (Central retinal arteriolar equivalent (CRAE), Central retinal venular equivalent (CRVE) and the arteriolar-venular ratio (AVR)) were measured. Data was analysed using the Statistical Package for Social Sciences version 27. Results Preeclamptic women exhibited higher cfPWV (7.63 ± 0.2 vs 7.26 ± 0.2, p = 0.05) and demonstrated a positive relationship between SBP (r = 0.41, p = 0.003), DBP (r = 0.63, p = 0.001), and cPWV. cfPWV showed a negative correlation with CRAE (r: −0.33, p = 0.02) and AVR (r: −0.44, p = 0.001) while ABI showed a positive association with CRAE (r = 0.47, p = 0.001). On the other hand, regression analysis demonstrated that AVR was negatively associated with arterial stiffness (β: −5.67; p = 0.008). Conclusion An existing relationship between microvascular and macro-vascular dysfunction was observed in women with preeclampsia. Retinal vascular changes were associated with arterial stiffness. These findings suggest that assessing retinal vessel calibers may serve as a non-invasive indicator of systemic vascular health in pregnancy-induced hypertensive disorders.

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