Ophthalmic Artery Doppler Evaluation in Pregnancy Complications

Ophthalmic artery Doppler evaluation provides a non-invasive window into maternal cerebral and orbital haemodynamics, which become altered in hypertensive and vascular complications of pregnancy. By assessing flow velocity waveforms in the ophthalmic artery, clinicians can detect changes in vascular resistance, perfusion pressure and flow pulsatility that parallel systemic endothelial dysfunction. Key parameters include resistance index, pulsatility index, peak systolic velocity and end-diastolic velocity, alongside derived metrics such as peak ratio and secondary systolic peaks. In preeclampsia and eclampsia, reductions in resistance and pulsatility indices reflect hyper­dynamic orbital flow and diminished vascular tone. These Doppler findings emerge before overt clinical signs, offering potential for early risk stratification and timely intervention. Beyond hypertensive disorders, emerging evidence suggests utility in other complications such as gestational diabetes and foetal growth restriction, where subtle microvascular alterations may presage adverse outcomes. Accessible, safe and repeatable, ophthalmic artery Doppler holds promise as a complementary tool in prenatal surveillance, integrating physiological insights with routine obstetric care to improve maternal and foetal prognosis worldwide.

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Ophthalmic Artery Doppler Evaluation in Pregnancy Complications publication trend

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Technical terms

Pulsatility Index (PI): A measure of the variation in blood flow velocity between systole and diastole, reflecting distal vascular resistance.

Resistance Index (RI): The ratio between peak systolic and end-diastolic velocity, used to quantify downstream impedance in a vessel.

Peak Systolic Velocity (PSV): The maximum blood flow speed during the systolic phase of the cardiac cycle.

End-Diastolic Velocity (EDV): The blood flow speed at the end of the diastolic phase, indicative of residual flow when the heart relaxes.

Peak Ratio (PR): The ratio of secondary systolic velocity to first systolic velocity, employed to enhance diagnostic accuracy in preeclamptic evaluation.

Second Systolic Peak (P2): A distinct secondary peak in the systolic portion of the Doppler waveform, associated with orbital hyperaemia in hypertensive disorders of pregnancy.

Ophthalmic Ratio: The quotient of specific systolic velocity measures, used in early screening studies to stratify preeclampsia risk.

Mean Enveloped Velocity: The average blood flow velocity over the cardiac cycle, derived from the Doppler waveform envelope.

References

1. Ophthalmic artery Doppler in the complementary diagnosis of preeclampsia: a systematic review and meta-analysis. BMC Pregnancy and Childbirth (2023).
2. Analysis of Ophthalmic Artery Doppler in Normotensive, Preeclamptic, and Eclamptic Pregnancies in Correlation With Clinical Parameters in a Tertiary Care Hospital in India. Cureus (2024).
3. Preeclampsia Management and Maternal Ophthalmic Artery Doppler Measurements between 19 and 23 Weeks of Gestation. Journal of Clinical Medicine (2024).
4. Study of ophthalmic artery hemodynamic pattern in pregnant women with gestational diabetes mellitus. Revista Brasileira de Ginecologia e Obstetrícia (2012).