International Journal of Clinical Obstetrics and Gynaecology

Aim: To compare maternal ophthalmic artery Doppler velocimetric indices in normotensive and hypertensive pregnancies.

Methods: This cross-sectional comparative study was conducted at a tertiary care center over 18 months. A total of 200 pregnant women were enrolled, comprising 100 hypertensive pregnancies (gestational hypertension/preeclampsia) and 100 normotensive controls. Detailed clinical evaluation, fundoscopy, baseline intraocular pressure measurement, and bilateral ophthalmic artery Doppler velocimetry were performed. Doppler parameters analyzed included peak systolic velocity (PSV1, PSV2), PSV2/PSV1 ratio, pulsatility index (PI), resistivity index (RI), and end-diastolic velocity (EDV). Statistical comparisons were performed using independent t-tests, with p< 0.05 considered significant.

Results: There were no significant differences between the two groups in maternal age or gestational age. Systolic and diastolic blood pressures and baseline intraocular pressure were significantly higher in the hypertensive group (p< 0.001). Hypertensive pregnancies demonstrated a significantly lower ophthalmic artery PSV ratio (right: 0.54 vs 1.09; left: 0.55 vs 1.11), reduced pulsatility index (right: 1.29 vs 2.12; left: 1.41 vs 2.11), and lower resistivity index (right: 0.71 vs 0.83; left: 0.68 vs 0.79) compared to normotensive controls (p? 0.001). No significant differences were observed in PSV1, PSV2, or EDV. Fundoscopic abnormalities were infrequent and limited to the hypertensive group.

Conclusion: Hypertensive pregnancies are associated with significant alterations in maternal ophthalmic artery Doppler indices, particularly reduced PSV ratio, PI, and RI, indicating impaired cerebral autoregulation and vascular dysfunction. Ophthalmic artery Doppler velocimetry is a valuable, non-invasive adjunct for assessing vascular changes in hypertensive disorders of pregnancy and may aid in early identification and risk stratification.