Preeclampsia and risk of ophthalmic complications: a large United States cohort study

To assess the association between preeclampsia in pregnancy and the development of ophthalmic complications. This retrospective cohort study included pregnant patients aged ≥18 years with preeclampsia (139,959) and without (1,935,751) in the TriNetX US Collaborative Network. We matched both cohorts using a propensity score (1:1) for demographics, comorbidities, and laboratory values. Our primary outcomes were the hazards of retinal vascular pathology, papilledema, and cortical visual impairment using Cox proportional hazard and Kaplan-Meier methods. Preeclampsia was associated with an increased lifetime risk of hypertensive retinopathy (aHR: 1.925; 95% CI: 1.349, 2.747), vascular occlusions (aHR: 1.926; 95% CI: 1.249, 2.970), papilledema (aHR: 1.637; 95% CI: 1.425, 1.881), and cortical visual impairment (aHR: 4.036; 95% CI: 2.427, 6.713). In preeclampsia patients ≥35 years, the risk of developing cortical visual impairment was further amplified, aHR: 6.817 (95% CI: 3.066, 15.154). Preeclampsia was significantly associated with significant ophthalmic changes, emphasising the importance of close monitoring during pregnancy.