FUNDUS CHANGES IN PREECLAMPSIA

Abstract

AIM To study the occurrence of fundus changes in preeclampsia and association between the severity of the disease, blood pressure and proteinuria with the fundus changes. METHODS This study included the patients who were admitted with the diagnosis of preeclampsia. Parameters such as age, gravida, gestation period, blood pressure and proteinuria were noted from the case sheets. Patients were asked for history of any ophthalmic complaints. The pupils were dilated and fundus examination was done with direct ophthalmoscope at bedside. All the findings were noted on a data sheet and were analysed using SPSS program. RESULTS Among the 46 patients diagnosed with preeclampsia, the mean age of patients was 27 years (range 19-35 years); the gestation period ranged from 25 weeks to 41 weeks; 24 (52.16%) were primigravida, 18 (39.13%) patients had mild preeclampsia, 27 (58.69%) had severe preeclampsia and 1 (2.18%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in 27 (58.69%) patients - Grade I in 24 (52.1%) and Grade II in 3 (6.5%). Haemorrhages or exudates or retinal detachment were not seen in any patient. There was statistically significant positive association of retinal changes and blood pressure (P=0.0139) and severity of the preeclampsia (P = 0.0114). However, there was no significant association between the fundus changes and proteinuria. CONCLUSION 59% of patients with preeclampsia had fundus changes (Grade I and II hypertensive retinopathy). This was significantly associated with blood pressure and severity of the disease. This study shows that fundus examination is an important tool in assessing the severity of preeclampsia.