Visual morbidity and spectrum of ophthalmic changes in pregnancy induced hypertension

To determine the prevalence of ocular changes in pregnancy-induced hypertension (PIH) and co-relate the ophthalmic changes and severity of the disease with visual outcome.

This is a retrospective study conducted from a hospital-based cohort of pregnant women, who delivered from June 2018 to December 2020. A total of 153 patients who fulfilled the diagnostic criteria of PIH admitted in the obstetric ward were included in this study. History with regard to age, parity, gravida, gestational age, medical history, and ocular findings were noted from the patient's case records. Anterior segment examination, dilated fundus evaluation, blood pressure (BP) recordings, urine proteinuria were done. All data were analyzed using the satistical package for social science (SPSS) program.

Out of 153 patients, 78 (50.98%) were primigravida, 55 (35.95%) were gravida 2, and 20 (13.07%) were multigravida. Gestational age ranged from 23-40 weeks. Ocular changes were seen in 57% of the PIH patients. Hypertensive retinopathy was seen in 23.53% of PIH patients with a mean age of 29.06 ± 4.36 years. Grade 1 hypertensive retinopathy was the most common manifestation in PIH patients (51.16%). The visual loss occurred in 72% of eclampsia and12% of pre-eclampsia which was statistically significant (P = 0.03). Papilledema was seen in 6% and refractive error in 41% of the patients.

Ocular examination of PIH patients reveals important objective information concerning the disorder. The presence of retinal change is a marker of the severity of PIH and is the most common ocular feature. Detection of progression of these changes reflects ischemic changes of the placenta. Fundus examination in PIH patients is important to predict adverse fetal outcomes, and risks to mother's life.