Pregnancy-induced hypertension
|
|
40 to 100%variable retinopathy |
↓ than half symptomaticretinal changes related to the severity of hypertension |
All |
Generally good |
Vasospasm(50–100% preeclampsia) |
Positive correlation (degree of retinopathy, severity of preeclampsia, maternal blood pressure and fetal mortality) |
Reversible, scotomas may persist for monthsRelated to the ocular fundus |
Punctate inner choroidopathy
|
|
Possible development of choroidal neovascular membranes during pregnancy |
|
First |
Reversible |
Central serous retinopathy
|
|
Spontaneous and localized serous detachment of the sensorineural retina in the macula |
Affects 0.008% ofpregnant women(90% of the female population affected) |
Third |
Reversible↑ the probability of recurrence outsidepregnancy/subsequent gestation |
Occlusive vascular diseases
|
→ Purtscher-like retinopathy |
Cotton wool spots and retinal hemorrhage |
|
Labor/Postpartum |
Reversible |
→ Disseminated intravascularcoagulation |
Thrombus dissemination (choroid involved)Serous detachment |
|
First/ Third |
Mostly reversibleEpithelial alterations may persist |
→ Thrombotic thrombocytopenicpurpura |
10% with retinal vascular occlusion, retinal hemorrhage, serous detachment, optic disc neovascularization |
Similar to Purtscher-like retinopathy (if the optic nerve vessels are involved) |
Third/ Postpartum |
Reversible |
→ Amniotic fluid embolism |
Retinal occlusions may occur |
Central retinal artery may be involved |
Labor/ Delivery/ Immediate postpartum |
Little attention(80% mortality rate) |
Diabetic retinopathy
|
|
Type 1 diabetes mellitus more associated with proliferative retinopathy |
Pregnancy (major and independent risk factor for the progression)Gestational diabetes without association |
First/ Second |
Reversible |
Uveitis
|
|
Not well-established |
Fewer recurrences |
All/ Postpartum |
Reversible |
Possible exacerbations |
First/Postpartum |
Antiphospholipid syndrome
|
|
Susceptible to arterial/venous thrombosis |
May include vascular thrombosis of the retina, choroid, optic nerve as well as oculomotor nerves |
All |
Reversible |
Ptosis
|
|
Different from oculomotor paralysis |
Ptosis, often unilateral, presents or worsens during pregnancy |
All |
Reversible |
Horner syndrome (may occur after epidural analgesia) |
Transient facial paralysis (↑ 3x) |
Hyperemesis gravidarum
|
|
Nystagmus and extraocular muscle paralysis |
If severe, it may lead to Wernicke encephalopathy |
First |
Reversible(with vitamin supplements) |
Optic neuropathy
|
|
Generally ischemic |
Severe antepartum/ postpartum hemorrhage may cause posterior ischemic optic neuropathy |
Third/ Postpartum |
Reversible |
↑ Incidence of anterior ischemic optic neuropathy |
Intraocular tumors
|
→ Pituitary adenoma |
Visual changes, bitemporal field defects, diplopia |
Surveillance is usually sufficient |
All |
Reversible |
→ Uveal melanoma |
Asymptomatic/paracentral scotoma/blurred visual acuity |
Etiology and growth uncertain |
All |
_ |
→ Choroidal osteoma |
Frequently asymptomatic |
Etiology of exacerbation unknown |
All |
Reversible |
→ Meningioma |
Proptosis/disc edema |
If preexisting, it may manifest |
Second half |
_ |
Other diseases
|
→ Graves' disease |
Vertical diplopia, proptosis, eyelid retraction, chemosis, periorbital edema |
Associated thyroid ophthalmopathy |
First/ Second/Postpartum |
Reversible |
→ Posterior scleritis |
Visual loss, serous retinal detachment, choroidal folds, subretinal mass |
|
All |
Reversible |
→ Immunological diseases |
Improvement in ocular and systemic manifestations |
↑ endogenous corticosteroids in pregnancy |
Recurrence postpartum (occasionally) |
Reversible |