Long-term Visual Functioning After Eclampsia

Abstract

OBJECTIVE:Complete neurocognitive recovery after eclampsia has been questioned with the expression of neurocognitive deficits by affected women and demonstration of cerebral white matter lesions on magnetic resonance imaging years after eclampsia. We hypothesized that formerly eclamptic women may experience impaired vision-related quality of life (QOL) and visual field loss as a result of the presence of such lesions in the cerebral visual areas. METHODS:Using the National Eye Institute Visual Function Questionnaire-39/Nederlands questionnaire, visionrelated QOL was compared between formerly eclamptic women and control participants after normotensive pregnancies. Furthermore, in formerly eclamptic women, visual fields were assessed using automated perimetry, and presence of white matter lesions was evaluated using cerebral magnetic resonance imaging. Presence of a relationship between these lesions and National Eye Institute Visual Function Questionnaire-39/Nederlands scores was estimated.

Ocular Changes During Pregnancy

“…[1,6,12]). Fortunately, cortical blindness and other visual changes resulting from eclampsia generally resolve within hours or days, although subjective visual impairment persists in rare cases (13).…”

Magnesium sulfate for eclampsia prevention: Quality of care evaluation in a tertiary centre in Québec, Canada

“…2 A small proportion of patients with preeclampsia go on to develop eclampsia (0.5%-3%), 3,4 which has been associated with persistent visual and neurological sequelae that may carry long-term consequences for the mother. [5][6][7][8] Forty percent of deaths from eclampsia are thought to be preventable. 9 The guidelines recommend the use of magnesium sulfate (MgSO 4 ) for prophylaxis in patients with severe preeclampsia (I-A 10,11 ) and for the treatment of eclampsia (I-A).…”

Cerebral Vasospasm in Cortical Blindness Associated with Preeclamsia/ Eclampsia Syndrome

“…Although, we know that Mg sulfate is better than nimodipine to prevent seizures in women with preeclampsia, we switched to nimodipine because the persistence of vasospasm determined by TCD [78][79][80]. In an effort to improve the symptoms, Mg sulfate infused over 6 days has been used in cortical blindness associated to preeclampsia [36,74].…”