Ophthalmic Complications in Preeclampsia
Summary
Preeclampsia is a multisystem disorder of pregnancy marked by hypertension and widespread endothelial dysfunction. Ocular complications arise in up to 10% of affected women and range from hypertensive retinopathy, characterised by arteriolar narrowing, retinal haemorrhages and papilloedema, to more severe manifestations such as serous or exudative retinal detachment. These changes stem from disrupted placental angiogenic balance and systemic vascular injury, leading to choroidal hypoperfusion, breakdown of the blood-retinal barrier and retinal pigment epithelium dysfunction. Clinically, patients may experience blurred vision, visual field defects, photopsia or sudden vision loss. In rare instances, cortical visual impairment predominates within a posterior reversible encephalopathy syndrome framework. The majority of ocular lesions improve rapidly after delivery and blood pressure control, yet early recognition is essential to prevent permanent deficits. Global studies underscore the importance of integrating ophthalmic screening into antenatal care, especially in resource-limited settings, and adopting a multidisciplinary approach that synchronises obstetric management with ophthalmic assessment to optimise maternal visual outcomes.
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Ophthalmic Complications in Preeclampsia publication trend
The graph below shows the total number of articles in ophthalmic complications in preeclampsia across all publications each year (not limited to Nature Index journals).
Technical terms
Hypertensive retinopathy: Retinal vascular changes including arteriolar narrowing, haemorrhages and papilloedema secondary to systemic hypertension.
Serous or exudative retinal detachment: Separation of the neurosensory retina from the retinal pigment epithelium due to subretinal fluid accumulation.
Optical coherence tomography (OCT): Non-invasive imaging modality that provides cross-sectional views of retinal and choroidal structures.
sFlt-1/PlGF ratio: Circulating balance of anti-angiogenic and pro-angiogenic factors used as a biomarker of preeclampsia severity.
References
- A Narrative Review on the Pathophysiology of Preeclampsia. International Journal of Molecular Sciences (2024).
- Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda: a cross-sectional study. BMJ Open (2023).
- Bilateral Serous Retinal Detachment and Posterior Reversible Encephalopathy Syndrome Precipitated by Eclamptic Attack. Cureus (2021).
- Bilateral Exudative Retinal Detachment in Preeclampsia: A Case Report and Literature Review. Cureus (2024).
- A Case Report of Bilateral Exudative Retinal Detachment in Severe Pre-eclampsia. Cureus (2024).
- Relationship between the sFlt-1/PlGF ratio and the optical coherence tomographic features of chorioretina in patients with preeclampsia. PLOS ONE (2021).
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