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Preeclampsia and risk of ophthalmic complications: a large United States cohort study

Eye (2026)Cite this article

Subjects

Abstract

Background/Objectives

To assess the association between preeclampsia in pregnancy and the development of ophthalmic complications.

Subjects/Methods

This retrospective cohort study included pregnant patients aged ≥18 years with preeclampsia (139,959) and without (1,935,751) in the TriNetX US Collaborative Network. We matched both cohorts using a propensity score (1:1) for demographics, comorbidities, and laboratory values. Our primary outcomes were the hazards of retinal vascular pathology, papilledema, and cortical visual impairment using Cox proportional hazard and Kaplan-Meier methods.

Results

Preeclampsia was associated with an increased lifetime risk of hypertensive retinopathy (aHR: 1.925; 95% CI: 1.349, 2.747), vascular occlusions (aHR: 1.926; 95% CI: 1.249, 2.970), papilledema (aHR: 1.637; 95% CI: 1.425, 1.881), and cortical visual impairment (aHR: 4.036; 95% CI: 2.427, 6.713). In preeclampsia patients ≥35 years, the risk of developing cortical visual impairment was further amplified, aHR: 6.817 (95% CI: 3.066, 15.154).

Conclusions

Preeclampsia was significantly associated with significant ophthalmic changes, emphasising the importance of close monitoring during pregnancy.

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Fig. 1: Cumulative Incidence (1- Survival) Curves Showing the Probability of Various Ophthalmic Complications in Pregnancy.

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Data availability

Data is available through the TriNetX online database.

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Authors and Affiliations

  1. Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS) Medical Center, Little Rock, AR, USA

    Sarah Jong, Fatma F. Shakarchi, Muhammad Z. Chauhan, Ahmed F. Shakarchi, Paul H. Phillips & Ahmed B. Sallam

  2. Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA

    Kaersti L. Rickels

  3. Department of Ophthalmology, Ain Shams University, Cairo, Egypt

    Ahmed B. Sallam

Authors
  1. Sarah Jong
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  2. Fatma F. Shakarchi
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  3. Kaersti L. Rickels
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  4. Muhammad Z. Chauhan
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  5. Ahmed F. Shakarchi
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  6. Paul H. Phillips
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  7. Ahmed B. Sallam
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Contributions

SJ—Design, conduct, data collection, data analysis, manuscript drafting, manuscript editing. FFS—Data analysis, manuscript drafting, manuscript editing. KLR—Design, conduct, data collection, data analysis, manuscript drafting, manuscript editing. MZC—Design, conduct, data collection, data analysis, manuscript drafting, manuscript editing. AFS—Design, conduct, data analysis, manuscript drafting, manuscript editing. PH—Design, conduct, data analysis, manuscript drafting, manuscript editing. ABS—Design, conduct, data collection, data analysis, manuscript drafting, manuscript editing.

Corresponding author

Correspondence to Ahmed B. Sallam.

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Jong, S., Shakarchi, F.F., Rickels, K.L. et al. Preeclampsia and risk of ophthalmic complications: a large United States cohort study. Eye (2026). https://doi.org/10.1038/s41433-026-04292-9

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