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DOI: http://dx.doi.org/10.21088/oas.2454.7816.3217.16

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.

Keywords: Gestational Hypertension; Eclampsia; Macular Edema. 

Corresponding Author : Y. Jaya Shanthi Latha, Associate Professor, Department of Ophthalmology, MediCiti Institute of Medical sciences, Ghanpur, Medchal District, Hyderabad, Telangana 501401