الفهرس 
Retinal changes in the context of normal pregnancy without pre-existing eye diseaseOnly 14 pages are availabe for public view
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Abstract
Retinal diseases in pregnancy are divided into:
E- Retinal changes in the context of normal pregnancy without pre-existing eye diseases:
4- Central serous chorioretinopathy (CSR): Pregnancy and psychological stress are known to produce hypothalamic-pituitary-adrenal axis abnormalities such as endogenous cortisol excess, a finding known to develop in some patients with CSR, diagnosed mainly by OCT, and usually resolve spontaneously.
5- Uveal Melanoma: which may occur due to increased level of melanocyte-stimulating hormone or estrogen and progesterone in pregnancy, and hase a poor prognosis.
6- Other rare disorders developing during normal regnancy: for example unilateral acute idiopathic maculopathy and choroidal osteoma associated with choroidal neovascularization.
F- Effects of pregnancy on preexisting disorders:
4- Diabetic Retinopathy (DR): The pathogenesis of DR during pregnancy is probably multifactorial. During pregnancy, physiological changes occur in the cardiovascular, hormonal, metabolic, hematological, and immune systems, by way of some of these changes, DR can deteriorate, even in those diabetic women with good metabolic control and minimal DR. Therefore diabetic pregnant female should have regular follow-up throughout pregnancy. DR usually regresses postpartum, although not necessarily returning to preconception. There is no evidence that preterm delivery or induced abortion would improve the patient’s prognosis.
5- Toxoplasmosis with pregnancy: it usually occurs due to recurrence of toxoplasmic retinochoroiditis due to pregnancy- associated immunomodulation. It is believed that pregnancy not only predisposes a patient for recurrence of ocular toxoplasmosis, but may also present favorable conditions for a more aggressive form of this disease. It usually treated with combination of anti toxoplasma therapy.
6- High myopia: pregnancy increases activity of many angiogenic factors which can stimulate retinal neovascularisation. There does not appear to be any contraindication to a spontaneous delivery in a high myopia.
G- Disorders associated with pregnancy-related disease:
1- Pregnancy-Induced hypertension:
• Retinopathy in pregnancy-induced hypertension: Focal arteriolar spasm similar to that associated with hypertensive retinopathy. Changes in retinal vessels were considered a risk factor for placental insufficiency and fetal mortality.
• Serous retinal detachment in pregnancy induced hypertension: Occurs due to ischemic infarcts of the choroid and most patients recover spontaneously to normal vision.
2- Occlusive Vascular Disorders: Pregnancy is associated with a hypercoagulable state in which both clotting factors and clotting activity are increased which may predispose to retinal artery occlusion, retinal vein occlusion and also disseminated intravascular coagulation.
3- Disorder related to labor and delivery:
• Purtscher’s-like retinopathy.
• Amniotic Fluid Embolism: it may be due to a biochemical process rather than mechanical vascular occlusion as it contains many particles that can activate vessels and also can activate the coagulation factors.
H- Use of diagnostic pharmacologic agents during pregnancy
1- Fluorescein angiography: Proved to cross the placenta and there is no evidence that it adversely affects the fetus, but it is better to be done when strongly indicated.
2- Indocyanine green angiography (ICG): ICG does not cross the placenta.
3- Topical anesthetics and dilating DROPs: No teratogenic effects have been reported, but it is better to be used with pressure on the nasolacrimal sac to minimize systemic absorption.