Department of Ophthalmology, AIIMS, Jodhpur, Rajasthan, India.
Indian J Ophthalmol. 2020 Aug;68(8):1526-1532. doi: 10.4103/ijo.IJO_2033_19.
The aim of this review article is to summarize the available literature on physiologic and pathologic ocular changes during pregnancy and the effect of diseases in pregnancy. A literature search was conducted using PUBMED, MEDLINE, and Cochrane library in English. In addition, the cited references in the published articles were manually reviewed for the relevant results. Pregnancy encompasses a multitude of changes in all body systems, including the visual system of the female. The changes can be physiological, i.e., changes occurring in the lids and adnexa, cornea, conjunctiva, changes in tear film composition and intraocular pressure, retina, choroid, and visual field. Pathological changes in a pregnant woman's eye include changes related to preeclampsia and eclampsia, central serous chorioretinopathy, retinal artery or vein occlusions, and disseminated intravascular coagulation. Preexisting diseases like diabetic retinopathy, Graves' disease, idiopathic intracranial hypertension, various inflammatory conditions can undergo changes in their course during pregnancy. Ophthalmic medications can have an effect on both mother and the baby and hence should be used cautiously. In addition, intrauterine infections play a major role in causing inflammation in the eye of the baby. Hence, vaccination of the mother prior to pregnancy plays an important role in preventing intrauterine infections in the neonate. A regular eye examination in the perinatal period plays a vital role in recognizing ophthalmic pathologies which might require a prompt medical intervention. Pathological ocular diseases should be discriminated from physiologic changes to establish an individualized treatment or preventive plan. This approach to ocular benefits of treatment to the mother should always weigh against the potential harm to the fetus.
这篇综述文章的目的是总结有关妊娠期间眼部生理和病理变化以及妊娠相关疾病对眼部影响的现有文献。我们使用 PUBMED、MEDLINE 和 Cochrane 图书馆的英文文献进行了文献检索。此外，还对已发表文章中的引用文献进行了手动审查，以获取相关结果。妊娠期间女性的身体系统会发生多种变化，包括视觉系统。这些变化可能是生理性的，即眼睑和附属器、角膜、结膜、泪膜成分和眼压、视网膜、脉络膜和视野的变化。孕妇眼部的病理性变化包括与子痫前期和子痫、中心性浆液性脉络膜视网膜病变、视网膜动脉或静脉阻塞以及弥漫性血管内凝血相关的变化。妊娠期间，如糖尿病视网膜病变、格雷夫斯病、特发性颅内高压等原有疾病的病程可能会发生变化。眼科药物可能会对母亲和婴儿产生影响，因此应谨慎使用。此外，宫内感染在引起婴儿眼部炎症方面起着重要作用。因此，母亲在怀孕前接种疫苗对于预防新生儿宫内感染至关重要。在围产期进行定期眼部检查对于识别可能需要及时医疗干预的眼部疾病至关重要。应该将病理性眼部疾病与生理性变化区分开来，以制定个体化的治疗或预防计划。这种以治疗对母亲的眼部益处为重点的方法应该始终权衡对胎儿的潜在危害。
