Saito Y, Tano Y
Department of Ophthalmology, Osaka University Medical School, Japan.
Retina. 1998;18(2):103-8. doi: 10.1097/00006982-199818020-00002.
Retinal and choroidal changes are considered uncommon ocular complications in preeclampsia. The authors evaluated preeclamptic and eclamptic patients to clarify the ophthalmologic features of preeclampsia.
The records of 71 women with severe preeclampsia or eclampsia were reviewed. Lesions related to choroidal circulatory disturbance were identified on review of patient fundus examinations and fluorescein angiograms.
Of 31 women whose records were evaluated, serous retinal detachments, yellowish, opaque retinal pigment epithelium (RPE) lesions, or both were present in 47 eyes (both lesions in 29 eyes, RPE lesions alone in 7 eyes, and serous retinal detachments alone in 11 eyes). Of the 36 eyes with RPE lesions, 33 (92%) had solitary or grouped lesions and 3 (8%) had large geographic lesions. The lesions were most commonly observed in the peripapillary area and macula. Lesions resolved without scarring in 3 weeks in 30 (83%) of these eyes. There was residual pigmentary mottling in three eyes (8.5%); in an additional three eyes (8.5%), all of which had had geographic lesions, significant chorioretinal atrophy developed.
The results suggest that the incidence of RPE lesions and serous retinal detachments, which are transient manifestations of choroidal ischemia, is high in patients with severe preeclampsia and eclampsia. These conditions resulted in significant scarring in only a small number of patients.
视网膜和脉络膜改变被认为是先兆子痫中不常见的眼部并发症。作者对先兆子痫和子痫患者进行评估，以明确先兆子痫的眼科特征。
回顾了71例重度先兆子痫或子痫女性的病历。通过检查患者眼底和荧光素血管造影来确定与脉络膜循环障碍相关的病变。
在评估病历的31例女性中，47只眼出现了浆液性视网膜脱离、淡黄色不透明视网膜色素上皮（RPE）病变或两者皆有（29只眼同时出现两种病变，7只眼仅有RPE病变，11只眼仅有浆液性视网膜脱离）。在36只出现RPE病变的眼中，33只（92%）有单个或成群的病变，3只（8%）有大片地图状病变。这些病变最常出现在视乳头周围区域和黄斑区。其中30只眼（83%）的病变在3周内消退且无瘢痕形成。三只眼（8.5%）有残留色素沉着斑；另外三只眼（8.5%），均有地图状病变，出现了明显的脉络膜视网膜萎缩。
结果表明，重度先兆子痫和子痫患者中，作为脉络膜缺血短暂表现的RPE病变和浆液性视网膜脱离的发生率很高。这些情况仅在少数患者中导致明显瘢痕形成。
