Cilioretinal obstruction during pregnancy

Abstract

Abstract Purpose To determine the number of patients diagnosed over a 5-year period with isolated occlusion of the cilioretinal artery (CRAO) whilst pregnant, as well as to describe the outcomes and ophthalmological sequelae of this condition in pregnant woman. Methods A retrospective study of the medical records. Results From the 135 patients diagnosed with retinal arterial occlusion of all of our series, 20 (14.8%) had CRAO, and 2 (1.48%) of these were pregnant. Case 1: a 34 year-old pregnant woman with a centrocaecal scotoma and visual acuity of 20/20 in right eye. Fundus examination: a soft exudate in the papillomacular bundle with retinal edema and embolism on a cilioretinal artery branch. The exudate and edema disappeared after 5 weeks, and the scotoma was reduced. Case 2: a 30 year-old pregnant woman, with normal visual acuity in right eye, and a centrocaecal scotoma. Fundoscopy: an area of retinal interpapillomacular infarction due to cilioretinal artery occlusion. The fundus returned to normal in 4 weeks, with an improvement of the scotoma. Conclusions The etiology of CRAO is usually associated with carotid disease or other thromboembolic events related to hypercoagulable states and autoimmunity. Pregnancy is considered a hypercoagulable state, and it is not known if it is a risk factor for arterial embolism. Further studies are required to determine the correlation between pregnancy and CRAO.