The Effect of Preeclampsia Severity on Chorioretinal Microvascular Circulation

PURPOSE: This study aimed to prospectively assess the impact of preeclampsia severity on chorioretinal microvasculature using optical coherence tomography angiography. METHODS: Sixty-six eyes from 66 patients were included and classified into mild (n = 33) and severe (n = 33) preeclampsia groups. Optical coherence tomography angiography imaging was performed before delivery, on the second day postpartum, and 6 weeks after delivery. Measurements at each time point were compared within and between groups. Correlations between optical coherence tomography angiography parameters and systemic blood pressure were also evaluated. RESULTS: In the mild preeclampsia group, deep capillary plexus vessel density increased significantly after delivery. In the severe preeclampsia group, both deep capillary plexus vessel density and radial peripapillary capillary vessel density showed significant increases postpartum. However, deep capillary plexus vessel density and radial peripapillary capillary vessel density values measured before delivery and on the second day postpartum were significantly lower in the severe preeclampsia group compared with the mild preeclampsia group. Significant negative correlations were found between deep capillary plexus vessel density, radial peripapillary capillary vessel density, and systemic blood pressure. CONCLUSION: Deep capillary plexus vessel density and radial peripapillary capillary vessel density are inversely correlated with systemic blood pressure and are affected by preeclampsia severity. Although microvascular density improves after delivery in both groups, recovery is slower in patients with severe preeclampsia, indicating a more prolonged vascular impact.