Danish Zafar, Zulfiqar Ali, Abdus Salam Arif.
IOP and Fundus Changes in Pregnancy.
Ophthalmol Update Jan ;12(1):18-21.

Objective: Pregnancy results in a lot of hormonal changes in the body and the eyes are no exception. These ocular changes could be physiologic, pathologic or a modification of a pre-existing condition. Pregnancy represents a real challenge to all body systems. Physiological changes can involve any of the body organs including the eye and visual system. The ocular effect of pregnancy involves a wide spectrum of physiologic and pathologic changes. The latter might be presenting for the first time during pregnancy such as corneal melting and corneal ectasia, or an already existing ocular pathologies that are modified by pregnancy such as diabetic retinopathy and glaucoma. In addition, pregnancy can affect vision through systemic disease that are either specific to the pregnant state itself such as the pre?eclampsia/eclampsia and Sheehan?s syndrome or systemic diseases that occur more frequently in relation to pregnancy such as Graves? disease, idiopathic intracranial hypertension, anti-phospholipid syndrome, and disseminated intravascular coagulation. The aim of this study was to determine ocular changes that are associated with pregnancy . Materials and Methods: A total of 150 women were followed longitudinally throughout the course of their pregnancy and 6 weeks postpartum. The women were recruited at 8 weeks of pregnancy at the anti-natal clinic in the Department of Obstetrics and Gynecology, Howta Sudair Hospital, Riyadh ,Saudi Arabia. The women were aged between 20 and 38 years. Tests carried out included visual acuity, ophthalmoscopy, and tonometry. The tests were carried out in each of the three trimesters of pregnancy and 6 weeks postpartum. Results: There was a fall in intraocular pressure across the trimesters and this was very significant (P<0.0001). During postpartum, the intraocular pressure began to rise. The difference between the third trimester and post-partum values were also statistically significant (P< 0.0001). 22 patients had pre-eclampsia and out of which 6 patients developed full blown eclampsia with fits, all these patients with pre-eclampsia showed mild hypertensive retinopathy, 1 out of 4 eclamptic patients had CSR. 68 patients were known diabetics, out of which 58 have non-proliferative diabetic retinopathy (NPDR), and 10 patients had early proliferative changes, which worsened during the course of the disease, for which they underwent PRP. 10 patients had raised blood sugar for first time during pregnancy with no fundus changes. Conclusion: Ocular changes associated with pregnancy are transient and most tend to resolve during postpartum period, proliferative diabetic changes enhanced during the course of pregnancy, so they should be closely observed.

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