Ocular Manifestations: Are They Significant in Hypertensive Disorders of Pregnancy?
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ORIGINAL ARTICLE
Ocular Manifestations: Are They Significant in Hypertensive Disorders of Pregnancy? Jyoti Ramesh Chandran1 · Indu B. Narayanan2 · Jincy Rajan1 Received: 24 June 2020 / Accepted: 13 October 2020 © Federation of Obstetric & Gynecological Societies of India 2020
Abstract Background Hypertensive disorders of pregnancy lead to pathological changes in various organ systems of mother and fetus which contributes to maternal and fetal morbidity and mortality. It is a multisystem disorder which can involve end organs like kidneys, liver, eyes, hemopoietic system and placenta. Retinal involvement, though quite common, is rarely investigated. It is a unique site where the blood vessels can be directly observed. Observing retinal vasculature may provide clue to status of similar vessels in other parts of body including placental circulation. Methods Hospital-based descriptive study which included 150 patients diagnosed as preeclampsia/eclampsia, who were admitted in the intensive care unit. Written consent was obtained from study subjects. Data were collected by history taking and examination of the subjects using pre-structured questionnaire. Ocular examination was carried out by ophthalmologist, which included anterior segment examination, visual acuity and dilated fundus examination. Multiple qualitative and quantitative parameters were studied. Data were analyzed by SPSS 14.0 software. Results Ocular symptoms were seen in 22% of severe preeclampsia and in 100% of eclampsia patients. Blurred vision was the most common ocular complaint. Fundus changes were seen in 48.7% total study subjects. Arteriolar narrowing was the most common finding on fundus examination. Systolic blood pressure and serum creatinine were found predictive of changes in fundus (p = .000). Incidence of fetal growth restriction was found to be significantly associated with fundus involvement (p value .000). Conclusion Ophthalmic examination including fundus examination should be a routine in the investigational armamentarium of hypertensive disorders of pregnancy. Keywords Eclampsia · Preeclampsia · Ocular manifestations · Fetal growth restriction
Introduction
Jyoti Ramesh Chandran is a Professor, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, India, and Indu B. Narayanan is a Senior Resident, Department of Ophthalmology, Government Medical College, Kozhikode, India. Jincy Rajan is a Senior Resident, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, India. * Jyoti Ramesh Chandran [email protected] 1
Department of Obstetrics and Gynecology, Government Medical College, Chnadra Villa, PO: West Hill, Chungam, Kozhikode, Kerala, India
Department of Ophthalmology, Government Medical College, Kozhikode, India
2
Pregnancy is associated with ocular changes, which most often are transient in nature. Either preexisting conditions exacerbate it or may be associated with development of new conditions. The ocular effects of pregnancy can be either physiological o
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