Preeclampsia Induced Ocular Change (original) (raw)

2017, International Journal of Women's Health and Reproduction Sciences

Introduction Preeclampsia, the most common medical complication of pregnancy, is characterized by elevated systemic blood pressure (>140/100 mm Hg), proteinuria (>300 mg/24 hours), and generalized edema, and it typically appears after the 20th week of pregnancy. It occurs in 5%-10% of all pregnancies (1). Severe preeclampsia presents with systemic blood pressure over 160/110 mm Hg, proteinuria 2 g/24 h, serum creatinine >2 mg/ dL, oliguria, thrombocytopenia, epigastric pain, cerebral and visual disruptions, headache, pulmonary edema, and elevated liver enzymes. In addition to the symptoms of preeclampsia, convulsions before or after birth indicates progression to eclampsia (1). Preeclampsia or eclampsia may develop retinal and choroidal circulation dysfunction and various fundoscopic findings and subsequent vision loss may occur as a result. These patients may have severe hypertensive retinopathy findings such as retinal hemorrhage, subretinal serous fluid accumulation, papilledema, and Elschnig spots. Other most common ocular complications that could be associated with (pre)eclampsia are Purtscherlike retinopathy, cortical blindness, retinal or vitreous hemorrhages serous retinal detachment, and central retinal vein occlusions. The visual symptoms may include blurred vision, double vision, sudden transient vision loss, flashing lights, and visual field complaints, including homonymous hemianopia (2). A dramatic endpoint of vision loss in preeclampsia is cortical blindness (3). This complication, though uncommon, that happens only in the severe preeclampsia is the sudden decreased vision (4). However, the loss of vision and serous retinal detachments accompanies the preeclamptic period generally and subsides in the postpartum period (5). It is thought that the degree of changes in retina of patients with preeclampsia/eclampsia may indirectly correlate with the severity of placental vascular alterations and as a result with insufficiency of placenta and low birth weight of fetus (6). Some authors believe that all women in childbearing ages should be evaluated of preeclampsia/ eclampsia if they have any retinal or choroidal findings of malignant hypertension (7). In this review, we discuss the definitions and proposed pathophysiology of preeclampsia/eclampsia as well as its potential role in ocular morbidity.