Thinning of specific retinal layers as a novel biomarker for adverse outcomes in high-risk pregnancy

Purpose: To investigate a potential association between retinal layer thinning and pregnancy-related adverse outcomes. Methods: A prospective observational study included 32 pregnant women between the ages of 18 and 45. Seventeen had uneventful pregnancies, and 15 experienced an adverse obstetrical outcome. Macular swept-source ocular coherence tomography was performed, and selective layers of the retina were evaluated. Adverse obstetrical outcome was defined as any of the following: preterm delivery, preeclampsia, pregnancy-induced hypertension, elevated liver function tests, thrombocytopenia and need for magnesium. Results: The inner superior ganglion cell layer (GCL) was found to be thinner in the cohort with composite adverse obstetrical outcomes than in the cohort without complications (84.5 ± 6.9 vs. 89.5 ± 6.1 μm respectively; P = 0.04). Total inner superior (295.5 ± 39.1 vs. 302.5 ± 12.7 μm; P = 0.03) and inferior retinal thickness (289.0 ± 13.9 vs. 301.0 ± 17.1 μm; P = 0.03) as well as total macular volume (7.5 ± 0.3 vs. 7.7 ± 0.3 mm³; P = 0.02) were also lower in women with adverse obstetrical outcomes. Conclusion: Thinning of the macular ganglion cell layer was associated with adverse outcomes in pregnancy. Larger studies are necessary to assess the potential role of macular GCL analysis in pregnancy.