Hypertensive disorders of pregnancy increase the risk of future ophthalmic disorders: a systematic review and meta-analysis

Whilst 30–60% of women with hypertensive disorders of pregnancy (HDP) suffer from ocular manifestations, longer term ophthalmic sequelae are unclear. We performed a systematic review and meta-analysis assessing the relationship between HDP and future ophthalmic morbidity, specifically retinal disorders (primary outcome) and/or other ophthalmic disorders (secondary outcomes). Four databases were searched until February 2025. Studies were screened according to inclusion/exclusion criteria, and quality assessed using the Newcastle–Ottawa scale. Random-effects was performed using generic inverse variance method, producing pooled odds ratios (ORs) with 95% confidence intervals (Cis). Eight studies were included (2 174 991 women; 5.40% HDP), typically of good ( n = 4) to fair ( n = 2) quality. Meta-analysis for retinal detachment and diabetic retinopathy were performed using two studies ( n = 1 211 724; 6% HDP). Preeclamptic women had near double odds of retinal detachment (1.87; 95% CI 1.57–2.22; I 2 = 0%) and over six times the odds of diabetic retinopathy (6.57; 95% CI 3.41–12.65; I 2 = 51%). Studies reported generally poorer ophthalmic outcomes in women with HDP.