title: PP049. The arterio-venous ratio of retinal vessels in the first trimester as a predictor for preeclampsia.
abstract: BACKGROUND
  Retinal changes are known in severe preeclampsia (PE). This is the first study evaluating static retinal vessel analysis in pregnancy to measure retinal vessel diameter and in women destined to develop preeclampsia.
  
  
  METHODS
  51 non-pregnant controls (29±4 years) and 601 pregnant women (30±6 years) arterio-venous ratio (AVR) of retinal arterioles and venules was measured with Dynamic Vessel Analyzer in 1. (12.1±2.5 weeks; T1), 2. (22.6±2.3 weeks; T2), 3. (33.1±3.8 weeks; T3) trimester and postpartum (19.1±15.3 weeks; pp).
  
  
  RESULTS
  38 women developed gestational hypertension (GH), while 143 developed PE. AVR [mean±SD] in the PE-group (28±6 years) was lower (p<0,02) in T1, T2, and pp compared to 420 women who remained normotensive during pregnancy (T1: 0.80±0.06 vs. 0.9±0.08; T2: 0.86±0.06 vs. 0.9±0.11; T3: 0.88±0.09 vs. 0.89±0.1; pp: 0.83±0.08 vs. 0.87±0.1). Non-pregnant controls (0.86±0.1) as well as normotensive pregnancies did not show any differences in AVR-values when compared to those who developed GH later in pregnancy (T1: 0.42±0.20; T2: 0.35±0.18; T3: 0.49±0.09; pp: 0.44±0.19). With a defined cut-off value of <0.83 AVR in the first trimester we were able to predict PE with a positive predictive value of 43.2% and a sensitivity of 86%.
  
  
  CONCLUSIONS
  AVR is lower in women susceptible for PE. These data are the first to provide evidence that microvascular changes of retinal vessels predate PE and even persist after delivery.
authors.forename: Andreas
authors.initials: A
authors.lastname: Brueckmann
authors.forename: Christin
authors.initials: C
authors.lastname: Seeliger
authors.forename: Markus
authors.initials: M
authors.lastname: Schwefer
authors.forename: Dietmar
authors.initials: D
authors.lastname: Schlembach
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Schleussner