Clinical retinal findings during the immediate postpartum period in patients with preeclampsia in a Mexican hospital

Abstract

Introduction and objective: Hypertensive disorders during pregnancy are one of the main obstetric complications in many countries. In preeclampsia, patients may perceive optical phenomena that can predict the evolution from preeclampsia to eclampsia, because ophthalmic changes manifest as a hypertensive retinopathy. The aim of this study is to describe the clinical retinal findings in patients diagnosed with preeclampsia in the immediate postpartum by indirect ophthalmoscopy. Material of methods: Descriptive, observational, prospective and cross-sectional study performed from August to December 2014, in patients diagnosed with preeclampsia admitted to a mother and child hospital, in the immediate postpartum, who underwent ophthalmic examination by indirect ophthalmoscopy. Fundus eye examination was performed describing clinical findings, and hypertensive retinopathy grading was done if present. Also, we evaluated a possible correlation between different factors that may influence the degree of hypertensive retinopathy. Results: Twenty-six patients with severe preeclampsia, 5 patients with mild preeclampsia and 1 patient with incomplete HELLP syndrome were examined, with a total of 32 patients enrolled. The prevalent clinical signs observed were vasospasm and arteriovenous crossings. We observed grade II hypertensive retinopathy in 34.61% of patients diagnosed with severe preeclampsia. Age was the main factor correlated with the degree of hypertensive retinopathy, with statistical significance (p = 0.044). Conclusions: Different grades of hypertensive retinopathy (grade I, II and III) were observed in patients with severe preeclampsia. No patients showed hypertensive neuropathy or choroidal ischemia associated with serous retinal detachment. Age is the main factor associated with the severity of hypertensive retinopathy.