Ronald Silverman, MD: Drawing Connections from the Eye to Preeclampsia

A study of patients with preeclampsia compared to those without found that the flow velocity was significantly higher in preeclampsia patients than in the normal controls.

Results from the ongoing study was presented at the 2019 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) in Vancouver, BC. Ronald Silverman, PhD, Professor of Ophthalmic Science, Columbia University Irving Medical Center, New York, spoke with MD Magazine® about the results and the ongoing research.

The data presented was from a small group of patients—8 with preeclampsia, 4 with chronic hypertension, and 9 controls. However, the investigators have continued to gather data on more patients.

In the abstract, investigators reported significant differences in peak systolic velocity in the central retinal vein (P = .035), in mean velocity in the central retinal artery (CRA; P = .018), end diastolic velocity in the CRA (P = .026) and short posterior ciliary artery (SPCA; P = .038), and resistive index and pulsatile index in CRA (P = .015 and .007) and SPCA (P = .012 and .016). There were higher velocities and lower resistance in participants with preeclampsia than in the controls.

In part 1 of the interview, Silverman shared about the rationale for turning to the eye to gain insights into preeclampsia.

What results did you see?

Is this research ongoing?

Now what the result was is that we discovered that the velocity of flow was significantly higher in preeclampsia patients than in the normal controls. However, we also discovered that the—and perhaps not surprisingly—that blood pressure the systemic blood pressure was also higher in the preeclampsia patients. So, once we took the blood pressure into account, we found that that was really the most significant factor, because blood flow velocity was actually proportional to the difference between systemic blood pressure and intraocular pressure. So, at this point we have identified an ocular parameter that is related to preeclampsia. The question is, can it be used predictively?In fact, the pace has been picking up. Everyone has gotten very excited about the results that we've obtained so far. In addition to the ultrasound that we're…that I've been mostly involved with, we're also taking optical coherence tomography and geography data on all of these patients. What this would give us is a map of the retinal vasculature and to some extent the choroidal vasculature.