Exploratory Associations Between Retinal Parameters and Selected Systemic Markers in Hypertensive Disorders of Pregnancy

Purpose: The purpose of this study was to explore associations between retinal parameters and selected systemic markers in hypertensive disorders of pregnancy (HDP). Methods: Retinal imaging was used to measure vessel diameter/tortuosity and thickness of the retinal nerve fiber layer (RNFL) and retina in participants. Uric acid (UA), aspartate aminotransferase (AST), 24-hour urine protein levels, and mean ocular perfusion pressure (MOPP) were assessed. Intergroup comparisons were performed using 1-way analysis of variance/nonparametric tests; correlations were analyzed using linear regression. Results: In total, 150 pregnant women were included: 87 normotensive controls, 32 with gestational hypertension (GH), and 31 with preeclampsia (PE). Across groups, arteriolar diameter decreased, temporal venular diameter and inferonasal arteriolar tortuosity increased (P < 0.001), and inferotemporal venular tortuosity decreased (P = 0.017). Nasal RNFL thickness increased (P < 0.001), with nonsignificant changes in other quadrants. No significant trends were noted for retinal thickness. MOPP interacted with nasal RNFL thickness (P < 0.05), but not with retinal thickness. The 24-hour urine protein and UA were associated with superotemporal venular and arteriolar diameters, respectively. MOPP was associated with inferotemporal, superonasal, and inferonasal arteriolar diameters, inferonasal arteriolar tortuosity, and central retinal arteriolar equivalent (P < 0.05). AST was not significantly associated with any retinal parameter. Conclusions: UA and 24-hour urine protein were associated with retinal vascular parameters, whereas AST was not significantly associated with any retinal parameter. These exploratory associations warrant prospective validation.