Structural and functional retinal changes during pregnancy in women with isolated intrauterine growth restriction and preeclampsia

Purpose: Structural and functional changes in the retina are associated with arterial hypertension and coronary artery disease. There is also a linkage between cardiovascular disease and intrauterine growth restriction (IUGR) as well as preeclampsia (PE). The aim of this study was to evaluate retinal vascular changes during pregnancy and postpartum in isolated PE without IUGR and isolated IUGR without PE/GH.

Material and methods: Arterio-venous-ratio (AVR) and flicked-induced-dilatation (FID) of retinal arterioles were measured with Dynamic Vessel Analyzer in 43 healthy pregnancies (HP), 28 pregnant women with isolated IUGR, and in 42 women with isolated PE at 1^st, 2^nd, 3^rd trimester, and postpartum (T1, T2, T3, and PP).

Results: In women with HP FID rises significantly from 2nd to 3 rd trimester before reaching the peak point in the postpartum period. Women with PE were found to have decreased AVR at T1 and increased FID at T1 and T2 when compared with HP, whereas in PE and IUGR FID was even significantly decreased postpartally in comparison to HP (table 1).

Tab. 1

	AVR (mean ± SD)			FID (%, mean ± SD)
	PE	IUGR	HP	PE	IUGR	HP
T1	0.78 ± 0.03 *	0.82 ± 0.07	0.89 ± 0.06 *	4.4 ± 1.9 *	4.7 ± 4.1	2.3 ± 1.5 *
T2	0.83 ± 0.07	0.93 ± 0.11	0.87 ± 0.12	4.7 ± 2.1 *	3.3 ± 1.9	2.7 ± 2.5 *
T3	0.85 ± 0.09	0.90 ± 0.14	0.88 ± 0.11	5.0 ± 3.0	5.0 ± 3.2	4.2 ± 2.4
PP	0.81 ± 0.08	0.90 ± 0.13	0.86 ± 0.12	3.4 ± 1.5 *	2.6 ± 1.8 *	5.9 ± 2.7 *
*= p < 0.05 versus HP

Conclusion: Retinal arteriolar narrowing as well as increased FID was seen in women with isolated preeclampsia but not with isolated IUGR. These findings indicate the different entities of isolated preeclampsia and IUGR displayed by the different symptoms. The drop of FID in PE and IUGR postpartally is linked to the shared placental abnormalities in both disorders.