Evaluation of Subfoveal Choroidal Thickness in Uncomplicated and Hypertensive Disorders of Pregnancy Using Spectral-Domain Optical Coherence Tomography and Its Postpartum Correlation

Purpose This study aimed to evaluate subfoveal choroidal thickness (SFCT) in women with uncomplicated pregnancy and those with hypertensive disorders of pregnancy (HDP), using spectral-domain optical coherence tomography (SD-OCT), and to assess changes in SFCT during the postpartum period. Methods The study was jointly carried out in the Departments of Ophthalmology and Obstetrics & Gynaecology at All India Institute of Medical Sciences, Bhopal, a tertiary care referral centre in central India, over a period of 18 months, from March 2021 to September 2022. A hospital-based cross-sectional study was conducted on pregnant women in their third trimester, including those with HDP and those with uncomplicated pregnancies. All participants underwent routine antenatal work-up, comprehensive ocular examination, and enhanced depth imaging optical coherence tomography (EDI-OCT) to measure SFCT. Follow-up assessments were performed at six weeks postpartum to evaluate postnatal changes in choroidal thickness. Results A total of 96 eyes from 48 pregnant women were evaluated. An overall increase in SFCT was observed in the postpartum period; however, this increase was not statistically significant, possibly due to the small sample size and loss to follow-up postpartum. In addition, the mean SFCT was higher in the uncomplicated pregnancy group compared to those with HDP, although this difference was also statistically insignificant. Despite limited statistical power, these findings suggest that HDP may influence choroidal thickness differently compared to normotensive pregnancies. Conclusion This study highlights the potential role of SFCT as a non-invasive biomarker for early identification and risk stratification of hypertensive disorders in pregnancy. Although the results did not reach statistical significance, the observed trends support the hypothesis that choroidal vascular changes may reflect underlying systemic vascular dysregulation in HDP. Future research with larger sample sizes and longer follow-up is warranted to validate these findings and to explore the utility of mean-adjusted choroidal thickness as a predictive marker for HDP severity and progression.