Relation of ocular fundus changes with blood pressure and proteinuria in pregnancy induced hypertension

Abstract

Context: Pregnancy induced hypertension (PIH) is defined as hypertensive disorder of pregnancy, which occurs in the absence of other causes of elevated blood pressure (BP) and is associated with pedal edema, proteinuria or both. Aims: To evaluate the ocular fundus changes and its relation with the severity of proteinuria and BP in PIH patients. Settings and Design: Hospital based prospective observational study. Subjects and Methods: Study conducted over a period of 2 years. A total 100 patients of pregnancy having preeclampsia and eclampsia were included. Statistical Analysis Used: Chi-square test. Results: Of 100 cases 32 (32%) had mild preeclampsia while 50 (50%) had severe preeclampsia. Eighteen (18%) patients had eclampsia. All cases had proteinuria of varying degree ranging from 1+ to 4+. Forty-four cases (44%) had retinal changes. Cases with severe proteinuria and higher BP had more severe grades of retinopathy. Conclusions: Examination of fundus by ophthalmoscope is simple, noninvasive, safe, and reliable procedure, which can be done in out-patient department or at bedside. It should be done routinely in all patients of PIH. It is the BP, systolic and diastolic to which the severity of the retinal changes was found to be directly proportional. Higher grades of proteinuria were associated with higher grades of retinal changes.