Ocular Changes in Hypertensive Disorders of Pregnancy – A Clinical Study
Journal Title: Ophthalmology and Allied Sciences - Year 2017, Vol 3, Issue 2
Abstract
Aim: To determine the prevalence of ocular changes in hypertensive disorders of pregnancy. Materials and Methods: This was a prospective observational study and it was conducted in period of 2years and it consisted of 100 subjects who fulfil the diagnostic criteria of hypertensive disorders of pregnancy. Results: Out of 100 patients, 61 patients had gestational hypertension, 23 had preeclampsia, and 15 had eclampsia, 2 had chronic hypertension and 1 had preeclampsia superimposed on chronic hypertension. Most of the fundus changes were seen in the 2225 age group. Fundus changes were observed in 21(21%) patients. Of these 21 patients with fundus changes, 19 patients had Grade I change, 1 patient had Grade II retinopathy change with retinal edema and macular edema and 1 patient had macular edema. Fundus changes were seen in 55.5% of preeclampsic and eclampsic patients. Out of 21 women who had preeclampsia, fundus changes were seen in 52.3% of them. Among 12 women who mild preeclampsia fundus changes were seen in 41.6%. Of 9 women with severe preeclampsia 66.6% had fundus changes. Out of 15 women who had eclampsia, fundus changes were seen 60% of them. Severe retinal changes like macular edema and Grade II retinopathy with retinal edema and macular edema were seen in eclampsic women. Visual disturbances were seen in 2 cases, out of these one patient had macular edema and the other had Grade II retinopathy change with retinal edema and macular edema. Most of the fundus changes (71.4%) were seen when the systolic blood pressure was 160 mm Hg. It was found that there was an increased incidence of retinal changes with an increase in systolic BP with a statically significant P value of 0.001. Fundus changes were seen only when the diastolic blood pressure was 100. It was found that there was an increased incidence of retinal changes with an increase in diastolic BP with a statistically significant P value of 0.0006. In this study out of 37 patients who had proteinuria, 19 patients had proteinuria of 1+ and retinal changes were seen in 5 (26.3%) of them, 14 patients had proteinuria of 2+ and retinal changes were seen in 11 (78.57%) of them and 4 patients had proteinuria of 3+ and retinal changes were seen in all (100%) of them. Conclusion: It can be concluded that fundus evaluation should be done in all patients with hypertensive disorders of pregnancy.
Authors and Affiliations
Y. Jaya Shanthi Latha
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