Effectiveness of Maternal Ophthalmic Artery Doppler for Preeclampsia

Background and Importance of Preeclampsia Assessment

Preeclampsia (PE) is a significant hypertensive disorder that can severely affect both maternal and fetal health, particularly in low-resource settings. Affecting approximately 5-8% of pregnancies globally, PE poses a risk of severe complications, including maternal mortality, fetal growth restriction, and preterm birth (Kulkarni et al., 2025). The condition typically arises after the 20th week of gestation and is characterized by hypertension and proteinuria. Early detection and management are crucial for improving outcomes, necessitating effective assessment methodologies.

Monitoring cerebrovascular changes associated with PE is vital due to the disease’s impact on cerebral autoregulation and endothelial function. Cerebrovascular dysfunction can lead to increased risks of neurological complications, including stroke (Kulkarni et al., 2025). Traditional imaging techniques, including MRI and CT, are often limited by cost, safety concerns, and logistical challenges in obstetric care. Therefore, there is a growing interest in alternative, non-invasive imaging modalities, such as ophthalmic artery Doppler (OAD) velocimetry, to evaluate the hemodynamic changes associated with PE.

Methodology for Evaluating Maternal Ophthalmic Artery Doppler

This study conducted a prospective observational case-control analysis involving 170 pregnant women, divided into two groups: 85 diagnosed with PE and 85 normotensive controls. Participants were recruited from a tertiary care medical facility between April 2023 and March 2025. The study was approved by the Institutional Ethics Committee (IEC/897/2022-23), and informed consent was obtained from all participants.

Utilizing high-resolution ultrasound with a 7-10 MHz transducer, key Doppler parameters were measured, including:

• Pulsatility Index (PI): A measure of the blood flow velocity in the ophthalmic artery.
• Resistivity Index (RI): Indicates the resistance to blood flow in the artery.
• Peak Systolic Velocity (PSV): The maximum speed of blood flow during heart contraction.
• End-Diastolic Velocity (EDV): The speed of blood flow during the heart’s relaxation phase.

Data were analyzed using IBM SPSS Statistics, applying independent t-tests for continuous variables and chi-square tests for categorical variables. Receiver Operating Characteristic (ROC) curves were utilized to determine cutoff values for assessing PE severity.

Key Findings: OAD Parameters in Preeclampsia Cases

The study revealed that women with PE exhibited significantly altered OAD parameters compared to the normotensive group. The mean values for these parameters are summarized in Table 1.

Table 1: OAD Parameters in Preeclampsia vs. Normotensive Controls

The analysis indicated that RI and PI values were significantly higher in the PE group, correlating with adverse maternal and fetal outcomes such as intrauterine growth restriction and preterm birth. The ROC analysis determined that an RI greater than 0.72 was a strong predictor of PE severity, with a sensitivity of 82.3% and specificity of 79.4%.

Implications for Clinical Practice and Future Research

The findings from this study underscore the potential of OAD velocimetry as a valuable non-invasive tool for assessing cerebrovascular alterations in PE. The significant differences in RI and PI values highlight the utility of this technique in identifying patients at risk for severe complications. Integrating OAD into routine obstetric evaluations can facilitate early detection and risk stratification, ultimately improving maternal and fetal outcomes.

Future research should focus on validating these findings across larger, multicenter cohorts to strengthen the evidence base for OAD as a standard assessment tool in obstetric care. Additional studies exploring the relationship between OAD parameters and long-term maternal and neonatal outcomes will further elucidate the clinical relevance of this technique.

FAQ

Q1: What is Preeclampsia? A1: Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, often affecting the liver and kidneys.

Q2: What is Maternal Ophthalmic Artery Doppler? A2: It is a non-invasive ultrasound technique used to assess blood flow in the ophthalmic artery, providing insights into cerebrovascular health in pregnant women.

Q3: How does OAD help in Preeclampsia? A3: OAD helps in identifying cerebrovascular dysfunction and assessing the severity of preeclampsia, allowing for timely interventions.

Q4: What are the implications of increased RI and PI in Preeclampsia? A4: Increased RI and PI values indicate higher vascular resistance, which may correlate with adverse maternal and fetal outcomes, highlighting the need for close monitoring.

Q5: What future research is needed? A5: Further studies are needed to confirm the findings in larger populations, explore the relationship between OAD parameters and long-term outcomes, and assess the cost-effectiveness of integrating OAD into routine care.

References

1. Kulkarni, S. S., Kori, S., Mudanur, S., & Shiragur, S. (2025). Prospective observational case-control study on the potential of maternal ophthalmic artery Doppler velocimetry in the evaluation of preeclampsia. Cureus, 16(8), e81983. https://doi.org/10.7759/cureus.81983

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