Toxicosis of pregnancy and eye changes

In the event that the pregnancy is normal, there are no changes in the vessels of the retina. As an exception, angiospasm and hyperemia of the optic nerve disk are sometimes observed without lowering visual acuity.

In early toxicosis of pregnant women, various variants of retinal angiopathy (vein dilatation, narrowing of arteries, tortuosity of individual arterioles, hyperemia of the optic nerve disk), retinal bleeding and retrobulbar neuritis may occur.

One of the forms of late toxicosis of pregnant women is nephropathy of pregnant women, in which the vascular system and kidneys are affected mainly and which is characterized by edema, arterial hypertension and proteinuria. Vascular disorders are found primarily in the study of the fundus: note the narrowing of the arteries and veins, retinal edema and even retinal detachment. In contrast to hypertensive disease with spasm of retinal arteries on the soil of toxicosis of pregnant women there is no compression of veins in the arteriovenous crossings.

A severe form of late toxicosis of pregnant women is eclampsia, characterized by the sudden appearance of seizures and loss of consciousness. Symptoms of nephropathy of pregnant women (edema, arterial hypertension, proteinuria) are aggravated by a painful headache, a feeling of heaviness in the head, dizziness, individual visual hallucinations, depressed mood, anxiety, lethargy, adynamia, visual disturbances (flies, fog, blurred vision, worsening vision up to its short-term loss), memory impairment, nausea, vomiting, diarrhea, puffiness of the face, cyanosis of the skin and mucous membranes. Especially severe is eclampsia with concomitant somatic diseases (hypertension, chronic glomerulonephritis and pyelonephritis, diabetes mellitus), as well as in women who have had encephalitis, meningitis, hepatitis, and rheumatic carditis. As eclampsia progresses, disorders of the functions of vital organs increase, which leads to hemorrhages in the brain, retinal detachment, hemorrhages into it, neuroretinopathy with loss of vision, renal, hepatic and respiratory insufficiency.

All medical measures are aimed at eliminating generalized spasm of blood vessels, hypovolemia, lowering arterial pressure, fighting with intoxication, improving microcirculation, etc. Control over diuresis, breathing, vision, and cardiovascular system is mandatory. With ineffective intensive care, a cesarean section is performed. One of the indications for its implementation are hemorrhages in the retina, its detachment and neuroretinopathy. Particular attention should be paid to women with high degree myopia and peripheral vitreoretinal dystrophies (latticed, cystic, cobblestone, pigmented), since in these cases there is a threat of detachment of the retina during delivery in a natural way. Argon preventive laser coagulation allows many pregnant women not to resort to caesarean section.