Optical coherence tomography angiography assessment of retinochoroidal microcirculation differences in preeclampsia

•Preeclampsia is a severe condition characterized by proteinuria, hypertension and multiple organ failure during pregnancy, and ocular pathology is observed in one third of patients.•In this study, foveal avascular zone and the superficial and deep central capillary plexus vascular density were lower in preeclamptic pregnant women compared to healthy pregnant women.•Choriocapillaris vascular density was higher in both preeclamptic and healthy pregnant women compared to non-pregnant controls.•In the preeclamptic group, FAZ area and choriocapillary vascular density increased with increasing systolic blood pressure.•Microvascular differences in the retina could be detected with OCTA before the detection of hypertensive retinopathy. To investigate microvascular changes in pregnant women with preeclampsia using optical coherence tomography angiography (OCTA) and compare the results with healthy pregnant and non-pregnant subjects. Superficial capillary plexus (SCP), deep capillary plexus (DCP) choriocapillaris (CC) vessel density (VD) and foveal avascular zone area (FAZ), retina, retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL) and the choroidal thickness were examined and compared in preeclamptic pregnant (group 1), healthy pregnant women (group 2) and non-pregnant, age-matched female controls (group 3). The correlations of the parameters with each other and with blood pressure were evaluated. No significant difference was found between the groups when retinal, RNFL and GCL thickness values (p> 0.05). The choroidal thickness values were significantly lower in group 1 than in group 2 (p = 0.029). The central foveal VD of the SCP and DCP was significantly lower in group 1 compared to groups 2 and 3 (p = 0.03, p< 0.01 respectively). The mean VD of the SCP was significantly higher in groups 1 and 2 than in group 3 (p = 0.01). The FAZ area was statistically significantly lower in group 3 than in group 2 (p = 0.032). The CC VD was lower in group 3 compared to the other groups in all measurements (p < 0.01).The FAZ area was positively correlated with systolic blood pressure in group 1. The use of OCTA, a non-invasive imaging technique, to assess the retinal microcirculation appears to have the potential to in the early diagnosis or follow up in preeclampsia before signs of hypertensive retinopathy.