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2016, Number 1

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Med Crit 2016; 30 (1)

Ophthalmological changes in pregnancy hypertensive disease

Ibarra SAA, Rivas CÁR, Sánchez MJR, Meza LE, Torres BJM
Full text How to cite this article

Language: Spanish
References: 9
Page: 43-47
PDF size: 185.37 Kb.


Key words:

Hypertensive disorders of pregnancy, fundoscopy, spastic angiopathy, phosphenes, prevention.

ABSTRACT

Introduction: Hypertensive disorders of pregnancy (HDP) complicates up to 10% of pregnancies worldwide, constituting high maternal and fetal morbimortality, causing visual symptoms or affection of the entire visual axis.
Objective: Identify ophthalmologic changes associated with HDP and establish its relationship with severity of illness.
Material and methods: We included 126 women, 63 with HDP (group I) including any of its variants, and 63 without HDP (group II) in a period from December 2013 to June 2014. Fundoscopic examination was performed twice in puerperal, an initial exam and two weeks later. Blood pressure (BP) was taken concurrently with the fundoscopy, at the initial exam and two weeks later.
Results: Severe preeclampsia (35%) was the predominant HDP disorder of group 1, 78% of this group showed ophthalmologic changes, prevailing changes were spastic angiopathy and prevailing symptoms were phosphenes; however, 43 patients of this group did not show symptoms (68%). Results found no ophthalmologic changes or symptoms in group II. Retinopathy grade was associated with the BP variations, with higher BP showing increased severity of retinopathy.
Conclusions: Retinopathy severity is associated with sustained hypertension in HDP. Fundoscopy permits to identify the evolution and severity of the illness so preventative proper measures can be taken.


REFERENCES

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  2. Jaramillo-Pérez R, Buces-Beaumont AJ, Orozco-Gomez LP. Correlación de hipertensión arterial sistémica y grado de retinopatía en pacientes adultos. Rev Mex Oftalmol. 2009;83(3):151-157.

  3. Gupta A, Kaliaperumal S, Setia S, Suchi ST, Rao VA. Retinopathy in preeclampsia: association with birth weight and uric acid level. Retina. 2008;28(8):1104-1110.

  4. Li LJ, Cheung CY, Ikram MK, Gluckman P, Meaney MJ, Chong YS, et al. Blood pressure and retinal microvascular characteristics during pregnancy: Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study. Hypertension. 2012;60(1):223-230.

  5. Reddy SC, Nalliah S, Who TS. Fundus changes in pregnancy induced hypertension. Int J Ophthalmol. 2012;5(6):694-697.

  6. Digre KB, Kinard K. Neuro-ophthalmic disorders in pregnancy. Continuum (Minneap Minn). 2014;20(1 Neurology of Pregnancy):162-176.

  7. Barbosa AS, Pereira AK, Reis ZS, Lage EM, Leite HV, Cabral AC. Ophthalmic artery-resistive index and evidence of overperfusion-related encephalopathy in severe preeclampsia. Hypertension. 2010;55(1):189-193.

  8. Lupton SJ, Chiu CL, Hodgson LA, Tooher J, Ogle R, Wong TY, et al. Changes in retinal microvascular caliber precede the clinical onset of preeclampsia. Hypertension. 2013;62(5):899-904.

  9. Wiegman MJ, de Groot JC, Jansonius NM, Aarnoudse JG, Groen H, Faas MM, et al. Long-term visual functioning after eclampsia. Obstet Gynecol. 2012;119(5):959-966.




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Med Crit. 2016;30