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박영주,박규형,우세준 대한안과학회 2017 Korean Journal of Ophthalmology Vol.31 No.4
Purpose: To report clinical features of patients with retinal and choroidal diseases presenting with acute visualdisturbance during pregnancy. Methods: In this retrospective case series, patients who developed acute visual loss during pregnancy (includingpuerperium) and visited a tertiary hospital from July 2007 to June 2015, were recruited by searchingelectronic medical records. Patients were categorized according to the cause of visual loss. Clinical featuresand required diagnostic modalities were analyzed in the retinal and choroidal disease group. Results: Acute visual loss occurred in 147 patients; 49 (38.9%) were classified into the retinal and choroidalgroup. The diagnoses included central serous chorioretinopathy (22.4%), hypertensive retinopathy with orwithout pre-eclampsia (22.4%), retinal tear with or without retinal detachment (18.4%), diabetic retinopathyprogression (10.2%), Vogt-Koyanagi-Harada disease (4.1%), retinal artery occlusion (4.1%), multiple evanescentwhite dot syndrome (4.1%), and others (14.3%). Visual symptoms first appeared at gestational age 25.9± 10.3 weeks. The initial best-corrected visual acuity (BCVA) was 0.27 ± 0.39 logarithm of the minimum angleof resolution (logMAR); the final BCVA after delivery improved to 0.13 ± 0.35 logMAR. Serious visual deterioration(BCVA worth than 20 / 200) developed in two patients. Differential diagnoses were established withcharacteristic fundus and spectral-domain optical coherence tomography findings in all cases. Conclusions: In pregnant women with acute visual loss, retinal and choroidal diseases are common and couldbe vision threatening. Physicians should be aware of pregnancy-associated retinal and choroidal diseasesand their clinical features. The differential diagnosis can be established with non-invasive techniques.
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