Preeclampsia Induced Ocular Change

Abstract

Objectives: Preeclampsia/eclampsia, the most common medical complication of pregnancy, can affect visual system as an end organ damage. Visual symptoms occur in 25% of patients with severe preeclampsia and 50% of patients with eclampsia. Visual system may be affected by hypertensive retinopathy, exudative retinal detachment, and cortical blindness. Methods: A literature search was conducted using MEDLINE, EMBASE, and Cochrane library until April 2017 in English and Persian. Additionally, extensive literature was searched using the Persian databases. Moreover, the cited references in the published articles were manually reviewed for relevant results. Results: The visual prognosis for ocular involvement was excellent in most cases because of its nature and high rate of spontaneous recovery, which occurred in a few weeks. The fact that there is a correlation between ocular finding and placental vascular abnormality emphasized correct diagnosis and evaluation of pregnant patients with visual changes. This review described the ocular involvement in pregnant patients with preeclampsia/eclampsia. The first purpose of this study was to discuss the pathophysiology and epidemiology of visual system involvement in preeclampsia/eclampsia. The second one was to diagnose the adverse effect on visual system as a last organ damage. Finally, in this review, the ophthalmologic finding, controversial issue of the treatment and prognosis with preventive care were discussed and monitoring methods for patients were followed up. Conclusions: Visual involvement is common in pregnancy-induced hypertension and retinal vascular changes are the most common ocular findings. It seems that the progression of these changes is a sign of increasing severity of pregnancy induced hypertension (PIH) and has correlated with fetal mortality. As a result, these findings may be guideline for prompt intervention as they may reflect similar ischemic vascular changes in the placenta. Although ocular involvement has a good prognosis in PIH, repeated observations, early diagnosis, and prompt management are essential for both maternal and fetal ultimate outcomes.