English

Abstract

BACKGROUND: Pre eclampsia is characterized by endothelial dysfunction and vasospasm of vessels which can be observed by an ocular fundal examination. The fundus usually develops changes like hypertensive retinopathy, papilledema, exudative retinal detachment, vitreous and pre retinal hemorrhages. Retinopathy is associated with placental insufficiency and intra uterine growth retardation. AIM: To assess the prevalence of fundal changes in preeclampsia and to study the association between degrees of hypertensive retinopathy changes in fundus and fetal outcome. METHODS: 100 patients presenting at department of obstetrics and gynecology diagnosed as pre eclampsia at R. L. Jalappa hospital from December 2011-June 2013 were recruited in the study. Patient recruited underwent ocular examination using snellens chart, pupillary examination, slit lamp examination and dilated fundal examination. The retinopathy was graded according to Keith and Wagner classification. The fetal parameters considered were birth weight, APGAR score, still birth and neonatal death. RESULTS: Patients age ranged from 17-28 years of age with average of 23.28±3.37. Average systolic and diastolic blood pressures were 156.9±17.961 and 104.88±13.58. All patients had normal anterior segment. 98% of patients had vision of 6/6.2%of them had 6/9. Based on retinopathy classification, we found 34 patients with grade 1 and 13 patients with grade 2 hypertensive retinopathy. Only 3 patients presented with grade3 hypertensive retinopathy. There was significant association of retinopathy with proteinuria, serum uric acid levels and the fetal birth weight with p value <0.05. CONCLUSION: Fundoscopy of retina is a simple, noninvasive, safe and reliable procedure to interpret the vascular changes. Therefore, it may be concluded that the degree of hypertensive retinopathy in women with preeclampsia is a valid and reliable prognostic factor that gives valid prognostic information on assessment of the severity of pre eclampsia and neonatal outcome.