CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2018; 40(01): 032-042
DOI: 10.1055/s-0037-1605366
Review Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Ocular Changes During Pregnancy

Alterações oftalmológicas na gravidez
Pedro Marcos-Figueiredo
1   Hospital Senhora da Oliveira (HSO), Guimarães, Portugal
,
Ana Marcos-Figueiredo
2   Centro Hospitalar do Porto (CHP), Porto, Portugal
,
Pedro Menéres
2   Centro Hospitalar do Porto (CHP), Porto, Portugal
3   Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto (ICBAS-UP), Porto, Portugal
,
Jorge Braga
3   Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Porto (ICBAS-UP), Porto, Portugal
4   Centro Materno-Infantil do Norte (CMIN), CHP, Porto, Portugal
› Author Affiliations
Further Information

Publication History

31 March 2017

30 June 2017

Publication Date:
07 August 2017 (online)

Abstract

Pregnancy is needed for the perpetuation of the human species, and it leads to physiological adaptations of the various maternal organs and systems. The eye, although a closed space, also undergoes some modifications, most of which are relatively innocuous, but they may occasionally become pathological. For women, pregnancy is a susceptibility period; however, for many obstetricians, their knowledge of the ocular changes that occur during pregnancy tends to be limited. For this reason, this is a important area of study as is necessary the development of guidelines to approach those changes. Of equal importance are the knowledge of the possible therapies for ophthalmological problems in this period and the evaluation of the mode of delivery in particular conditions. For this article, an extensive review of the literature was performed, and a summary of the findings is presented.

Resumo

A gravidez é necessária à perpetuação da espécie humana, levando a adaptações fisiológicas dos diversos órgãos e sistemas maternos. O olho, apesar de uma cavidade fechada, sofre também algumas modificações, a maioria relativamente inócuas, que pontualmente poderão se tornar patológicas. A gravidez assume-se como um período particular de suscetibilidade para a mulher; no entanto, muitos obstetras têm conhecimento limitado sobre as alterações oftalmológicas na gravidez. Por conseguinte, impõe-se o seu estudo, bem como a elaboração de diretrizes para lidar com essas mudanças. De igual importância são o conhecimento da eventual terapêutica para problemas oftalmológicos neste período e a avaliação do tipo do parto em condições particulares. Desta forma, foi efetuada uma revisão bibliográfica extensa e apresentada uma síntese do tema.

 
  • References

  • 1 Gouveia EB, Conceição PS, Morales MS. [Ocular changes during pregnancy]. Arq Bras Oftalmol 2009; 72 (02) 268-274
  • 2 Samra KA. The eye and visual system in pregnancy, what to expect? An in-depth review. Oman J Ophthalmol 2013; 6 (02) 87-91
  • 3 Mackensen F, Paulus WE, Max R, Ness T. Ocular changes during pregnancy. Dtsch Arztebl Int 2014; 111 (33-34): 567-575 , quiz 576
  • 4 Chawla S, Chaudhary T, Aggarwal S, Maiti GD, Jaiswal K, Yadav J. Ophthalmic considerations in pregnancy. Med J Armed Forces India 2013; 69 (03) 278-284
  • 5 Altay Y, Altay MM, Demirok G, Balta O, Bolu H. Measurements of pupillary diameter and wavefront aberrations in pregnant women. Scientifica (Cairo) 2016; 2016: 4129524
  • 6 Riss B, Riss P. Corneal sensitivity in pregnancy. Ophthalmologica 1981; 183 (02) 57-62
  • 7 Akar Y, Yucel I, Akar ME, Uner M, Trak B. Long-term fluctuation of retinal sensitivity during pregnancy. Can J Ophthalmol 2005; 40 (04) 487-491
  • 8 Schultz KL, Birnbaum AD, Goldstein DA. Ocular disease in pregnancy. Curr Opin Ophthalmol 2005; 16 (05) 308-314
  • 9 Pizzarello LD. Refractive changes in pregnancy. Graefes Arch Clin Exp Ophthalmol 2003; 241 (06) 484-488
  • 10 Efe YK, Ugurbas SC, Alpay A, Ugurbas SH. The course of corneal and intraocular pressure changes during pregnancy. Can J Ophthalmol 2012; 47 (02) 150-154
  • 11 Green K, Phillips CI, Cheeks L, Slagle T. Aqueous humor flow rate and intraocular pressure during and after pregnancy. Ophthalmic Res 1988; 20 (06) 353-357
  • 12 Kara N, Yildirim Y, Tekirdag AI. , et al. Effect of body posture on intraocular pressure and ocular perfusion pressure in nonglaucomatous pregnant women. Curr Eye Res 2013; 38 (01) 80-85
  • 13 Kara N, Sayin N, Pirhan D. , et al. Evaluation of subfoveal choroidal thickness in pregnant women using enhanced depth imaging optical coherence tomography. Curr Eye Res 2014; 39 (06) 642-647
  • 14 Ataş M, Açmaz G, Aksoy H. , et al. Evaluation of the macula, retinal nerve fiber layer and choroid in preeclampsia, healthy pregnant and healthy non-pregnant women using spectral-domain optical coherence tomography. Hypertens Pregnancy 2014; 33 (03) 299-310
  • 15 Ulusoy DM, Duru N, Ataş M, Altınkaynak H, Duru Z, Açmaz G. Measurement of choroidal thickness and macular thickness during and after pregnancy. Int J Ophthalmol 2015; 8 (02) 321-325
  • 16 Sayin N, Kara N, Pirhan D. , et al. Subfoveal choroidal thickness in preeclampsia: comparison with normal pregnant and nonpregnant women. Semin Ophthalmol 2014; 29 (01) 11-17
  • 17 Dadaci Z, Alptekin H, Oncel Acir N, Borazan M. Changes in choroidal thickness during pregnancy detected by enhanced depth imaging optical coherence tomography. Br J Ophthalmol 2015; 99 (09) 1255-1259
  • 18 Karki P, Malla P, Das H, Uprety DK. Association between pregnancy-induced hypertensive fundus changes and fetal outcomes. Nepal J Ophthalmol 2010; 2 (01) 26-30
  • 19 Gupta A, Kaliaperumal S, Setia S, Suchi ST, Rao VA. Retinopathy in preeclampsia: association with birth weight and uric acid level. Retina 2008; 28 (08) 1104-1110
  • 20 Kaliaperumal S, Setia S, Gupta A, Rao VA. Fetal birthweight and diastolic blood pressure: association with retinopathy in severe preeclampsia. Eur J Ophthalmol 2008; 18 (05) 809-812
  • 21 Erbagci I, Karaca M, Ugur MG, Okumus S, Bekir NA. Ophthalmic manifestations of 107 cases with hemolysis, elevated liver enzymes and low platelet count syndrome. Saudi Med J 2008; 29 (08) 1160-1163
  • 22 Sim DA, Sheth HG, Kaines A, Tufail A. Punctate inner choroidopathy-associated choroidal neovascular membranes during pregnancy. Eye (Lond) 2008; 22 (05) 725-727
  • 23 Best RM, Chakravarthy U. Diabetic retinopathy in pregnancy. Br J Ophthalmol 1997; 81 (03) 249-251
  • 24 Morrison JL, Hodgson LA, Lim LL, Al-Qureshi S. Diabetic retinopathy in pregnancy: a review. Clin Experiment Ophthalmol 2016; 44 (04) 321-334
  • 25 Lövestam-Adrian M, Agardh CD, Aberg A, Agardh E. Pre-eclampsia is a potent risk factor for deterioration of retinopathy during pregnancy in Type 1 diabetic patients. Diabet Med 1997; 14 (12) 1059-1065
  • 26 Lauszus F, Klebe JG, Bek T. Diabetic retinopathy in pregnancy during tight metabolic control. Acta Obstet Gynecol Scand 2000; 79 (05) 367-370
  • 27 Rabiah PK, Vitale AT. Noninfectious uveitis and pregnancy. Am J Ophthalmol 2003; 136 (01) 91-98
  • 28 Chiam NP, Hall AJ, Stawell RJ, Busija L, Lim LL. The course of uveitis in pregnancy and postpartum. Br J Ophthalmol 2013; 97 (10) 1284-1288
  • 29 Garweg JG, Scherrer J, Wallon M, Kodjikian L, Peyron F. Reactivation of ocular toxoplasmosis during pregnancy. BJOG 2005; 112 (02) 241-242
  • 30 Kump LI, Androudi SN, Foster CS. Ocular toxoplasmosis in pregnancy. Clin Experiment Ophthalmol 2005; 33 (05) 455-460
  • 31 Shields CL, Shields JA, Eagle Jr RC, De Potter P, Menduke H. Uveal melanoma and pregnancy. A report of 16 cases. Ophthalmology 1991; 98 (11) 1667-1673
  • 32 Chung CY, Kwok AK, Chung KL. Use of ophthalmic medications during pregnancy. Hong Kong Med J 2004; 10 (03) 191-195
  • 33 Ness T, Paulus W. [Eye and pregnancy.]. Ophthalmologe 2010; 107 (09) 863-872 , quiz 873
  • 34 Labetoulle M, Gendron G, Offret H. [Eyedrops in children and pregnant or breast-feeding woman: why so many difficulties?]. J Fr Ophtalmol 2009; 32 (02) 135-150
  • 35 Ho JD, Hu CC, Lin HC. Antiglaucoma medications during pregnancy and the risk of low birth weight: a population-based study. Br J Ophthalmol 2009; 93 (10) 1283-1286
  • 36 Lee AG, Pless M, Falardeau J, Capozzoli T, Wall M, Kardon RH. The use of acetazolamide in idiopathic intracranial hypertension during pregnancy. Am J Ophthalmol 2005; 139 (05) 855-859
  • 37 Tarantola RM, Folk JC, Boldt HC, Mahajan VB. Intravitreal bevacizumab during pregnancy. Retina 2010; 30 (09) 1405-1411
  • 38 Sheth BP, Mieler WF. Ocular complications of pregnancy. Curr Opin Ophthalmol 2001; 12 (06) 455-463
  • 39 Halperin LS, Olk RJ, Soubrane G, Coscas G. Safety of fluorescein angiography during pregnancy. Am J Ophthalmol 1990; 109 (05) 563-566
  • 40 Olk RJ, Halperin LS, Soubrane G, Coscas G. Fluorescein angiography--is it safe to use in a pregnant patient?. Eur J Ophthalmol 1991; 1 (02) 103-106
  • 41 Fineman MS, Maguire JI, Fineman SW, Benson WE. Safety of indocyanine green angiography during pregnancy: a survey of the retina, macula, and vitreous societies. Arch Ophthalmol 2001; 119 (03) 353-355
  • 42 Inglesby DV, Little BC, Chignell AH. Surgery for detachment of the retina should not affect a normal delivery. BMJ 1990; 300 (6730): 980
  • 43 Meshi A, Armarnik S, Mimouni M. , et al. The effect of labor on the intraocular pressure in healthy women. J Glaucoma 2017; 26 (01) 59-64
  • 44 Ataş M, Duru N, Ulusoy DM. , et al. Evaluation of anterior segment parameters during and after pregnancy. Cont Lens Anterior Eye 2014; 37 (06) 447-450
  • 45 Chiu H, Steele D, McAlister C, Lam WC. Delivery recommendations for pregnant females with risk factors for rhegmatogenous retinal detachment. Can J Ophthalmol 2015; 50 (01) 11-18
  • 46 Papamichael E, Aylward GW, Regan L. Obstetric opinions regarding the method of delivery in women that have had surgery for retinal detachment. JRSM Short Rep 2011; 2 (04) 24