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Review

Evaluating the Chorioretinal Microcirculation in Preeclampsia with OCT-Angiography: A Narrative Literature Review

by
Evita Evangelia Christou
1,2,*,
Ariel Yuhan Ong
1,3,4,
Charlotte Frise
5,
Assad Jalil
2,
Tsveta Ivanova
2,
Ilias Georgalas
6 and
Samantha R. de Silva
1,7
1
Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
2
Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
3
Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
4
Institute of Ophthalmology, University College London, London WC1E 6BT, UK
5
Queen Charlotte’s and Chelsea Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, UK
6
First Department of Ophthalmology, General Hospital G. Gennimatas, National and Kapodistrian University of Athens, 115 27 Athens, Greece
7
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(11), 3913; https://doi.org/10.3390/jcm14113913
Submission received: 22 April 2025 / Revised: 24 May 2025 / Accepted: 29 May 2025 / Published: 2 June 2025
(This article belongs to the Special Issue Retinal Diseases: Recent Advances in Diagnosis and Treatment)
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Abstract

Background/Objectives: The retinal microvasculature may reflect systemic vascular health and can be non-invasively imaged using optical coherence tomography angiography (OCTA). Investigation of the capillary plexuses in the macula and the peripapillary area could potentially provide insights into the pathophysiology of ocular manifestations in preeclampsia. We aimed to review the literature on OCTA metrics in preeclampsia to evaluate its use in this condition. Methods: A literature search was performed using the PubMed database, and studies published up to December 2024 were included. Results: We summarized the current evidence on chorioretinal microvascular changes in pregnancy and the ocular manifestations of preeclampsia. We reported findings from seven published studies characterizing the chorioretinal capillary plexuses in preeclampsia using OCTA. These revealed changes in microvasculature characteristics, such as foveal avascular zone size and vessel density in the macula and the peripapillary area; however, there was variability in reported parameters. Conclusions: Microvascular changes in the chorioretinal capillary plexus in preeclampsia were reported by several studies; however, results were inconsistent and may have been affected by multiple factors. Nevertheless, OCTA may have diagnostic and prognostic value, by providing evidence of microcirculation sequalae and aiding our understanding of ocular manifestations in this condition. Further studies are warranted to establish appropriate OCTA acquisition protocols and metrics, and whether these could guide clinical practice in preeclampsia.
Keywords: macular microcirculation; peripapillary capillary plexus; choriocapillaris; optical coherence tomography angiography; preeclampsia; hypertensive disorder in pregnancy macular microcirculation; peripapillary capillary plexus; choriocapillaris; optical coherence tomography angiography; preeclampsia; hypertensive disorder in pregnancy

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MDPI and ACS Style

Christou, E.E.; Ong, A.Y.; Frise, C.; Jalil, A.; Ivanova, T.; Georgalas, I.; de Silva, S.R. Evaluating the Chorioretinal Microcirculation in Preeclampsia with OCT-Angiography: A Narrative Literature Review. J. Clin. Med. 2025, 14, 3913. https://doi.org/10.3390/jcm14113913

AMA Style

Christou EE, Ong AY, Frise C, Jalil A, Ivanova T, Georgalas I, de Silva SR. Evaluating the Chorioretinal Microcirculation in Preeclampsia with OCT-Angiography: A Narrative Literature Review. Journal of Clinical Medicine. 2025; 14(11):3913. https://doi.org/10.3390/jcm14113913

Chicago/Turabian Style

Christou, Evita Evangelia, Ariel Yuhan Ong, Charlotte Frise, Assad Jalil, Tsveta Ivanova, Ilias Georgalas, and Samantha R. de Silva. 2025. "Evaluating the Chorioretinal Microcirculation in Preeclampsia with OCT-Angiography: A Narrative Literature Review" Journal of Clinical Medicine 14, no. 11: 3913. https://doi.org/10.3390/jcm14113913

APA Style

Christou, E. E., Ong, A. Y., Frise, C., Jalil, A., Ivanova, T., Georgalas, I., & de Silva, S. R. (2025). Evaluating the Chorioretinal Microcirculation in Preeclampsia with OCT-Angiography: A Narrative Literature Review. Journal of Clinical Medicine, 14(11), 3913. https://doi.org/10.3390/jcm14113913

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