Retinal vascular disorders during pregnancy: An observational study

Abstract

Aim: To determine the prevalence and pattern of retinal vascular disorders in pregnant women. Materials and Methods: This hospital based, prospective observational study was conducted over a period of two years. Patients were selected from outpatient department and antenatal ward of Department of Obstetrics and Gynecology and outpatient department of Ophthalmology, SS Hospital, IMS, BHU, Varanasi. In all cases detailed obstetric history including age, gravida, gestational age, general and antenatal examination and relevant pathological investigations like blood sugar, blood urea, serum creatinine and urinary protein were carried out. After taking ocular history, detailed ocular examination including visual acuity and fundus examination under mydriasis with 1% tropicamide eye drop was carried out. All the findings were recorded on a data sheet and were analyzed using SPSS programme. The Chi-Square test was used to evaluate the association between the various antenatal factors and retinal vascular changes. Results: Of 210 patients 38.09% patients were primigravida and 28.57% were second gravida. 28.57% had pregnancy induced hypertension (PIH), 13.33 % had gestational diabetes mellitus, 12.38% had preexisting diabetes mellitus. Fundus abnormalities were observed in 110 (52.38%) cases among them commonest retinal pathology was hypertensive retinopathy 38 (34.55%) followed by diabetic retinopathy (32.73%), retinal vein occlusion (16.36%) and central serous chorioretinopathy (7.27%). Out of 60 cases of PIH 38 (63.33%) had retinal abnormalities. Retinal vascular disorders were seen in > 80% cases of severe pre-eclampsia and about 90% cases of eclampsia. Majority (68.42%) of PIH patient had grade I hypertensive retinopathy. The commonest retinal change was arterial attenuation (28.57%) followed by dot and blot hemorrhage (21.90%), A-V crossing changes (20.48%), hard exudates (19.05%), flame shaped hemorrhage (42.56%) and macular edema (18.10%). However in 5.71% cases papill