A Narrative Review of the Complex Relationship between Pregnancy and Eye Changes

Abstract

Pregnancy is a condition often characterized by changes that occur in different parts of the body. Generally, the eyes suffer several changes during pregnancy that are usually transient but may become permanent at times. This may occur due to the release of placental hormones and those of maternal endocrine glands and fetal adrenal glands. Due to hormonal influences, physiological ocular changes during pregnancy have been shown in Caucasian women, so corneal sensitivity, refractive status, intraocular pressure, and visual acuity may change during pregnancy. Within this review, all studies that referred to physiological aspects and to changes of ocular pathology of pregnancy, the effect of the pregnancy on pre-existing (diabetic retinopathy, neuro-ophthalmic disorders) eye disorders, postpartum ocular changes, the intraocular pressure and the effect of hypotensive ophthalmic medicine during pregnancy, the connection between pregnancy and the neuro-ophthalmic pathology, as well as the role of anesthesia were analyzed.

A Narrative Review on Neuro-Ophthalmological Manifestations That May Occur during Pregnancy

“…Certain pre-existing eye conditions are known to either deteriorate or improve during this period, though these changes are typically temporary. What further complicates diagnosis and management is the limitation that ophthalmic medications commonly prescribed for individuals who are not pregnant cannot be used in the same manner during pregnancy or while breastfeeding due to associated risks to the fetus [6,[14][15][16].…”

“…These physiological shifts lead to an increased occurrence of vascular diseases. This includes conditions like retinal artery occlusion, spontaneous orbital hemorrhage, and pituitary apoplexy, among others [1][2][3][4][5][6].…”

“…Eclampsia and preeclampsia involve severe hypertension and proteinuria, typically occurring after the 20th week of gestation. The reported cases involve retinopathy with Purtscher-like changes associated with a serous retinal detachment that occurs in pregnant women recognized with preeclampsia, as well as those secondary to HELLP syndrome [6][7][8].…”

“…Nevertheless, specialized literature also discusses rare occurrences of optic neuritis attacks during the first trimester of pregnancy and rare cases of myelin oligodendrocyte glycoprotein optic neuritis (MOG-ON). Identifying AQP4-Ab (aquaporin 4-antigen) and MOG-Ab (oligodendrocyte glycoprotein antibodies) is pivotal for individuals having optic neuritis undergoing various therapies, as these may lead to different prognoses [6][7][8].…”

The Role of Estriol and Estrone in Keratoconic Stromal Sex Hormone Receptors

“…Sex hormones are accessible to all tissues through blood circulation; however, specific receptors are required for these hormones to function and have an impact. During pregnancy, the fluctuation of sex hormones has been correlated to causing corneal alterations in curvature, central corneal thickness, and corneal volume [23][24][25]. It is believed that these hormonal changes exacerbate the progression of KC during pregnancy and can extend up to six months postpartum [18].…”