Impairment of retinal and choroidal blood flow autoregulation in preeclampsia

Preeclampsia is a leading cause of maternal and perinatal mortality, which makes the search for methods of early preclinical diagnosis highly relevant. Ocular microcirculation, owing to its similarity to cerebral and placental vessels, represents a unique “window” for assessing systemic endothelial dysfunction. The study provides a comprehensive analysis of current data on the association between impaired autoregulation of retinal and choroidal blood flow in preeclampsia and the risk of systemic hemodynamic and cerebrovascular complications. Unlike physiological vasodilation, preeclampsia is characterized by autoregulatory failure, which leads to hyperperfusion and a risk of vasogenic cerebral edema in cerebral vessels, while in the retina it manifests as vasospasm detectable as early as the first trimester. Choroidal changes remain contradictory and reflect complex systemic hemodynamic shifts. Impaired ocular vascular hemodynamics serves as an early marker of systemic endotheliopathy, and its monitoring represents a promising tool for risk stratification of cerebrovascular and long-term cardiovascular complications.