Retinal Vascular Changes During Pregnancy Detected With Optical Coherence Tomography Angiography

Purpose: To evaluate retinal vascular status during pregnancy by using optical coherence tomography angiography (OCTA). Methods: Women in their third trimester of pregnancy and nonpregnant age-matched women were recruited for this prospective, case-control study. Subjects were imaged with OCTA. Main outcome measures were foveal avascular zone parameters, perfusion density (PD) percentage in the superficial retinal capillary plexus (SCP), PD percentage in the deep retinal capillary plexus (DCP), SCP vessel length density (VLD), DCP-VLD, and choriocapillaris (CC) flow voids (i.e., flow deficits in the CC). Results: Nineteen eyes of 10 pregnant subjects and 44 eyes of 27 nonpregnant control women were included. Mean ages were 36 ± 7 and 35 ± 8 years (SD), respectively (P value = 0.78). Mean gestational age of pregnant women was 33 weeks (range = 29-39, SD = 3). There was a significant reduction in the SCP-PD in the entire scan and in the nasal Early Treatment Diabetic Retinopathy Study subfield (47.9 vs. 49.7, P = 0.04 and 49.3 vs. 51.6, P = 0.03, respectively) in the pregnant cohort versus controls. There was a significant increase in the DCP-PD in the parafoveal region and in the temporal and inferior Early Treatment Diabetic Retinopathy Study subfields (58.0 vs. 55.9, P = 0.03; 57.9 vs. 55.5, P = 0.02; 58.0 vs. 55.9, P = 0.05, respectively) in the pregnant cohort. There was no significant difference in foveal avascular zone parameters, SCP-VLD, DCP-VLD, or CC flow voids between the two populations. Conclusions: This study detected retinal vasculature changes in the third trimester of pregnancy. Mean SCP-PD was significantly decreased and mean DCP-PD was significantly increased without a difference in VLD.