International Ophthalmology

, Volume 39, Issue 9, pp 2069–2076 | Cite as

Choroidal thickness in preeclampsia measured by spectral-domain optical coherence tomography

  • Camila Zanella BenficaEmail author
  • Teresinha Zanella
  • Lucas Brandolt Farias
  • Maria Lúcia Rocha Oppermann
  • Luis Henrique Santos Canani
  • Daniel Lavinsky
Original Paper



To compare choroidal thickness (CT) measurements in preeclamptic and healthy women in the third trimester of pregnancy using optical coherence tomography.


This cross-sectional study included 148 eyes of 74 women, divided into two groups: 27 healthy pregnant women in the third trimester (control group) and 47 age-matched pregnant women in the third trimester with preeclampsia (PE group). Of the 47 subjects in preeclampsia group, 26 were classified as having mild PE and 21 as having severe PE. Choroidal thickness was measured at ten different locations: at the fovea and every 500 µm from the fovea up to 2500 µm temporally and up to 2000 µm nasally.


Comparing CT of both groups, choroid always tended to be thicker in subjects with preeclampsia in comparison with healthy pregnant women, with statistical significance in nasal measures. Dividing PE group according to disease severity, women with severe preeclampsia tended to have thicker choroids in comparison with mild preeclamptic and healthy pregnant women. Choroid was also significantly thicker in preeclamptic patients with serous retinal detachment (SRD) in comparison with preeclamptic patients without SRD (P < 0.01 in all macular points).


Our study showed that choroid tends to be thicker in patients with preeclampsia, with statistical significance only in nasal measures. In patients with SRD, however, choroid is markedly thicker at all points analyzed. From these findings we can hypothesize that preeclampsia can cause a choroidal thickening, which begins in the peripapillary area. As the imbalance increases, the entire choroid becomes thickened.


Preeclampsia Pregnancy Choroidal thickness Optical coherence tomography Serous retinal detachment 


Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.


  1. 1.
    Amaral L, Wallace K, Owens M, LaMarca B (2017) Pathophysiology and current clinical management of preeclampsia. Curr Hypertens Rep 19:61CrossRefGoogle Scholar
  2. 2.
    Yenerel N, Küçümen R (2015) Pregnancy and the eye. Turk J Ophthalmol 45:213–219CrossRefGoogle Scholar
  3. 3.
    Jaffe G, Schatz H (1987) Ocular manifestation of preeclampsia. Am J Ophthalmol 103:309–315Google Scholar
  4. 4.
    Mabie WC, Ober RR (1980) Fluorescein angiography in toxaemia of pregnancy. Br J Ophthalmol 64:666–671CrossRefGoogle Scholar
  5. 5.
    Iida T, Kishi S (2002) Choroidal vascular abnormalities in preeclampsia. Arch Ophthalmol 120:1406–1407CrossRefGoogle Scholar
  6. 6.
    Valluri S, Adelberg DA, Curtis RS, Olk RJ (1996) Diagnostic indocyanine green angiography in preeclampsia. Am J Ophthalmol 122:672–677CrossRefGoogle Scholar
  7. 7.
    Ramaesh K, Nagendran S, Saunders D (1999) Choroidal ischaemia and serous retinal detachment in toxaemia of pregnancy. Eye 13:795–796CrossRefGoogle Scholar
  8. 8.
    Querques L, Querques G, Loperfido F, Lattanzio R, Bandello F (2013) Enhanced depth imaging optical coherence tomography findings associated with serous retinal detachment in preeclampsia. Arch Gynecol Obstet 289:457–459CrossRefGoogle Scholar
  9. 9.
    Belfort MA, Saade GR (1993) Retinal vasospasm associated with visual disturbance in preeclampsia: colour flow Doppler findings. Am J Obstet Gynecol 169:523–525CrossRefGoogle Scholar
  10. 10.
    Spaide RF, Koizumi H, Pozonni MC (2008) Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 146:496–500CrossRefGoogle Scholar
  11. 11.
    Neudorfer M, Spierer O, Goder M, Newman H, Barak S, Barak A, Asher-Landsberg I (2014) The prevalence of retinal and optical coherence tomography findings in preeclamptic women. Retina 34:1376–1383CrossRefGoogle Scholar
  12. 12.
    Zhang J, Wang H, Yu Q, Tong Q, Lu Q (2017) Enhanced depth imaging optical coherence tomography: a new way measuring choroidal thickness in pregnant women. J Ophthalmol 2017:8296574Google Scholar
  13. 13.
    American College of Obstetricians and Gynecologists (2013) Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstet Gynecol 122:1122–1131CrossRefGoogle Scholar
  14. 14.
    Tan C, Ouyang Y, Ruiz H, Sadda S (2012) Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci 53:261–266CrossRefGoogle Scholar
  15. 15.
    Chakraborty R, Read S, Collins M (2011) Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics. Invest Ophthalmol Vis Sci 52:5121–5129CrossRefGoogle Scholar
  16. 16.
    Chhablani J, Barteselli G, Wang H et al (2012) Repeatability and reproducibility of manual choroidal volume measurements using enhanced depth imaging optical coherence tomography. Invest Ophthalmol Vis Sci 53:2274–2280CrossRefGoogle Scholar
  17. 17.
    Branchini L, Regatieri C, Flores-Moreno I, Baumann B, Fujimoto J, Duker J (2012) Reproducibility of choroidal thickness measurements across three spectral domain optical coherence tomography systems. Ophthalmology 119:119–123CrossRefGoogle Scholar
  18. 18.
    Koay C, Quo M, Subrayan V (2017) Reproducibility of choroidal thickness measurements in subjects on 3 spectral domain optical coherence tomography machines. Int Ophthalmol 37:655–671CrossRefGoogle Scholar
  19. 19.
    Henderson J, Thompson J, Burda B, Cantor A (2017) Preeclampsia screening: evidence report and systematic review for the US preventive services task force. JAMA 317:1668–1683CrossRefGoogle Scholar
  20. 20.
    Palei A, Spradley F, Warrington J, George E, Granger J (2013) Pathophysiology of hypertension in pre-eclampsia: a lesson in integrative physiology. Acta Physiol 208:224–233CrossRefGoogle Scholar
  21. 21.
    Sathish S, Arnold JJ (2000) Bilateral choroidal ischaemia and serous retinal detachment in pre-eclampsia. Clin Exp Ophthalmol 28:387–390CrossRefGoogle Scholar
  22. 22.
    AlTalbishi A, Khateb S, Amer R (2015) Elschnig’s spots in the acute and remission stages in preeclampsia: spectral-domain optical coherence tomographic features. Eur J Ophthalmol 25:84–87CrossRefGoogle Scholar
  23. 23.
    Ataş M, Açmaz G, Aksoy H, Demircan S, Ataş F, Gülhan A, Zararsız G (2014) Evaluation of the macula, retinal nerve fiber layer and choroid in preeclampsia, healthy pregnant and healthy non-pregnant women using spectral-domain optical coherence tomography. Hypertens Pregnancy 33:299–310CrossRefGoogle Scholar
  24. 24.
    Garg A, Wapner R, Ananth C, Dale E, Tsang S, Lee W, Allikmets R, Bearelly S (2014) Choroidal and retinal thickening in severe preeclampsia. Invest Ophthalmol Vis Sci 55:5723–5729CrossRefGoogle Scholar
  25. 25.
    Kim J, Park M, Kim Y, Kim Y (2015) Comparison of subfoveal choroidal thickness in healthy pregnancy and pre-eclampsia. Eye 30:349–354CrossRefGoogle Scholar
  26. 26.
    Duru N, Ulusoy D, Özköse A, Ataş M, Karatepe A, Ataş F, Arifoglu HB, Yılmaz U (2016) Choroidal changes in pre-eclampsia during pregnancy and the postpartum period: comparison with healthy pregnancy. Arq Bras Oftalmol 79:143–146CrossRefGoogle Scholar
  27. 27.
    Sayin N, Kara N, Pirhan D et al (2013) Subfoveal choroidal thickness in preeclampsia: comparison with normal pregnant and nonpregnant women. Semin Ophthalmol 29:11–17CrossRefGoogle Scholar
  28. 28.
    Wei WB, Xu L, Jonas JB et al (2013) Subfoveal choroidal thickness: the Beijing eye study. Ophthalmology 120:175–180CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Universidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  2. 2.Department of OphthalmologyHospital de Clínicas de Porto AlegrePorto AlegreBrazil
  3. 3.Department of Gynecology and ObstetricsHospital de Clínicas de Porto AlegrePorto AlegreBrazil
  4. 4.Department of EndocrinologyHospital de Clínicas de Porto AlegrePorto AlegreBrazil

Personalised recommendations