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先兆子痫的病人40-100%有视网膜改变。但失明者少见。一般视力丧失是由于视网膜动脉循环障碍。作者报告1例先兆子痫病人因视乳头筛板前部供血损害而失明。女性32岁妊娠32周,血压170/110 mmHg,尿蛋白4+。搏动性头痛后视力模糊,半小时内下降至光感。检查时双眼已无光感,双视乳头苍白,视网膜小动脉轻度变细。因高血压口服二氮嗪(diazoxide)后血压下降,视乳头暂时变红,视力逐渐恢复,产后3天双眼视力恢复至6/7.5后3周恢复至6/6。先兆子痫的眼底改变主要是视网膜动脉痉挛及视网膜水肿、点状出血、渗出及视网膜脱离。眼底改变轻微而失明的病例有人认为是由于枕叶缺血或癔病所致。作者报告的病例根据视网膜血管改变很少而视乳头严重苍白,从而支持急性缺血性视神经病变是主要的致盲原因。
40-100% of patients with preeclampsia have retinal changes. But blindness is rare. The general loss of vision is due to circulatory disorders of the retina. The authors report that 1 patient with preeclampsia was blind due to blood supply to the front of the optic disc. 32-week-old female 32-year-old pregnancy, blood pressure 170/110 mmHg, urinary protein 4 +. Pulsatile visual acuity after a headache, half an hour fell to light feeling. Check the eyes have no light feeling, double vision nipple pale retinal arterioles mild thinning. The blood pressure dropped after diazoxide was given to hypertension, the optic disc became red temporarily and vision gradually recovered. The binocular visual acuity was restored to 6/6 in 3 weeks after 6/3.5 postpartum. Fundus changes in preeclampsia are mainly retinal artery spasms and retinal edema, punctate bleeding, exudation and retinal detachment. Occasionally slight and blind cases of change were considered due to occipital lobe ischemia or hysteria. The authors reported cases of retinal vasculopathy with few changes and severe papillae, thus supporting acute ischemic optic neuropathy is the main cause of blindness.