Naderan Mohammad
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Curr Ophthalmol. 2018 Jan 3;30(3):202-210. doi: 10.1016/j.joco.2017.11.012. eCollection 2018 Sep.
To summarize available literature on physiologic and pathologic ocular changes during pregnancy.
Narrative review of literature.
Ocular changes occur commonly during pregnancy. Although most of these are benign physiologic responses to the metabolic, hormonal, and immunologic modifications to adopt the gestational product, there is some serious pathology that may develop, exacerbate, or even resolve over the course of pregnancy which requires prompt diagnosis and management. The pathological eye conditions can be classified into preexisting pathologies and emerging ocular diseases. Regardless of the different mechanisms by which these ocular changes occur, the key point is the establishment of an effective perinatal screening program to monitor the new development or successive progression of these ocular abnormalities. Irrespective of the visual health status of the pregnant women, regular perinatal eye examination should be scheduled in order to assure continuous surveillance of healthy eyes. Treatment of pathologic ocular conditions or functionally disturbing benign changes relies on an appropriate patient selection.
Discriminating pathological eye disease from physiologic ocular changes is important in order to establish an individualized treatment or preventive plan and constitutes the mainstay of obstetric ophthalmology. This individualized approach should always weigh the ocular benefits of treatment to the mother against the potential harms to the fetus.
总结关于孕期眼部生理和病理变化的现有文献。
对文献进行叙述性综述。
孕期眼部变化常见。尽管其中大多数是对代谢、激素和免疫改变的良性生理反应,以适应妊娠产物,但仍有一些严重病变可能在孕期发生、加重甚至缓解,这需要及时诊断和处理。病理性眼部疾病可分为既往存在的病变和新出现的眼部疾病。无论这些眼部变化发生的机制如何,关键是建立有效的围产期筛查程序,以监测这些眼部异常的新发展或连续进展。无论孕妇的视力健康状况如何,都应安排定期围产期眼部检查,以确保对健康眼睛进行持续监测。病理性眼部疾病或功能性干扰性良性变化的治疗依赖于适当的患者选择。
区分病理性眼病和生理性眼部变化对于制定个体化治疗或预防计划很重要,是产科眼科的主要内容。这种个体化方法应始终权衡治疗对母亲的眼部益处与对胎儿的潜在危害。