Skip to main content
NCBI home page
Transactions of the American Ophthalmological Society logoLink to Transactions of the American Ophthalmological Society
. 1985;83:114–130.

Toxemia of pregnancy pigment epitheliopathy masquerading as a heredomacular dystrophy.

D M Gass, S E Pautler
PMCID: PMC1298693  PMID: 3832523

Abstract

Patients with toxemia of pregnancy may develop permanent alterations of the pigment epithelium that if first discovered in later life may be mistaken for a heredomacular dystrophy, a diffuse tapetoretinal dystrophy or other diseases. These nonprogressive changes are caused by multifocal areas of fibrous platelet occlusion of the choriocapillaris that usually occur just prior to or following delivery and is usually associated with a transient period of exudative retinal detachment. The pattern of pigment epithelial derangement is often sufficiently characteristic to suggest the correct diagnosis.

Full text

PDF
114

Images in this article

115FIGURE 1 A
on p.115
115FIGURE 1 B
on p.115
115FIGURE 1 C
on p.115
115FIGURE 1 D
on p.115
116FIGURE 2 A
on p.116
116FIGURE 2 B
on p.116
116FIGURE 2 C
on p.116
116FIGURE 2 D
on p.116
117FIGURE 3 A
on p.117
117FIGURE 3 B
on p.117
117FIGURE 3 C
on p.117
117FIGURE 3 D
on p.117
119FIGURE 4 A
on p.119
119FIGURE 4 B
on p.119
119FIGURE 4 C
on p.119
119FIGURE 4 D
on p.119
120FIGURE 5 A
on p.120
120FIGURE 5 B
on p.120
121FIGURE 6 A
on p.121
121FIGURE 6 B
on p.121
122FIGURE 7 A
on p.122
122FIGURE 7 B
on p.122
122FIGURE 7 C
on p.122
124FIGURE 8 A
on p.124
124FIGURE 8 B
on p.124
124FIGURE 8 C
on p.124
125FIGURE 9 A
on p.125
125FIGURE 9 B
on p.125
125FIGURE 9 C
on p.125

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beecham J. B., Watson W. J., Clapp J. F., 3rd Eclampsia, preeclampsia, and disseminated intravascular coagulation. Obstet Gynecol. 1974 Apr;43(4):576–585. [PubMed] [Google Scholar]
  2. Cogan D. G. Ocular involvement in disseminated intravascular coagulopathy. Arch Ophthalmol. 1975 Jan;93(1):1–8. doi: 10.1001/archopht.1975.01010020005001. [DOI] [PubMed] [Google Scholar]
  3. Collier R. H. Experimental embolic ischemia of the choroid. Arch Ophthalmol. 1967 May;77(5):683–692. doi: 10.1001/archopht.1967.00980020685025. [DOI] [PubMed] [Google Scholar]
  4. Dornan K. J., Mallek D. R., Wittmann B. K. The sequelae of serous retinal detachment in preeclampsia. Obstet Gynecol. 1982 Nov;60(5):657–663. [PubMed] [Google Scholar]
  5. Fastenberg D. M., Fetkenhour C. L., Choromokos E., Shoch D. E. Choroidal vascular changes in toxemia of pregnancy. Am J Ophthalmol. 1980 Mar;89(3):362–368. doi: 10.1016/0002-9394(80)90005-7. [DOI] [PubMed] [Google Scholar]
  6. Folk J. C., Weingeist T. A. Fundus changes in toxemia. Ophthalmology. 1981 Nov;88(11):1173–1174. doi: 10.1016/s0161-6420(81)34889-1. [DOI] [PubMed] [Google Scholar]
  7. Gitter K. A., Houser B. P., Sarin L. K., Justice J., Jr Toxemia of pregnancy. An angiographic interpretation of fundus changes. Arch Ophthalmol. 1968 Oct;80(4):449–454. doi: 10.1001/archopht.1968.00980050451008. [DOI] [PubMed] [Google Scholar]
  8. Hsieh R. C., Fine B. S., Lyons J. S. Patterned dystrophies of the retinal pigment epithelium. Arch Ophthalmol. 1977 Mar;95(3):429–435. doi: 10.1001/archopht.1977.04450030071006. [DOI] [PubMed] [Google Scholar]
  9. Kenny G. S., Cerasoli J. R. Color fluorescein angiography in toxemia of pregnancy. Arch Ophthalmol. 1972 Apr;87(4):383–388. doi: 10.1001/archopht.1972.01000020385003. [DOI] [PubMed] [Google Scholar]
  10. Klien B. A. Ischemic infarcts of the choroid (Elschinig spots). A cause of retinal separation in hypertensive disease with renal insufficiency. A clinical and histopathologic study. Am J Ophthalmol. 1968 Dec;66(6):1069–1074. [PubMed] [Google Scholar]
  11. LANDAU J., SADOWSKY A., SERR D. M. Retinal changes and fetal prognosis in the toxemias of pregnancy. Obstet Gynecol. 1956 Oct;8(4):426–431. [PubMed] [Google Scholar]
  12. Mabie W. C., Ober R. R. Fluorescein angiography in toxaemia of pregnancy. Br J Ophthalmol. 1980 Sep;64(9):666–671. doi: 10.1136/bjo.64.9.666. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Martin V. A. Disseminated intravascular coagulopathy. Trans Ophthalmol Soc U K. 1978;98(4):506–507. [PubMed] [Google Scholar]
  14. McKay D. G. Hematologic evidence of disseminated intravascular coagulation in eclampsia. Obstet Gynecol Surv. 1972 Jun;27(6):399–417. doi: 10.1097/00006254-197206000-00001. [DOI] [PubMed] [Google Scholar]
  15. Oliver M., Uchenik D. Bilateral exudative retinal detachment in eclampsia without hypertensive retinopathy. Am J Ophthalmol. 1980 Dec;90(6):792–796. doi: 10.1016/s0002-9394(14)75194-3. [DOI] [PubMed] [Google Scholar]
  16. Pritchard J. A., Cunningham F. G., Mason R. A. Coagulation changes in eclampsia: their frequency and pathogenesis. Am J Obstet Gynecol. 1976 Apr 15;124(8):855–864. doi: 10.1016/s0002-9378(16)33390-7. [DOI] [PubMed] [Google Scholar]
  17. Roberts J. M., May W. J. Consumptive coagulopathy in severe preeclampsia. Obstet Gynecol. 1976 Aug;48(2):163–166. [PubMed] [Google Scholar]
  18. Sibai B. M., Anderson G. D., McCubbin J. H. Eclampsia II. Clinical significance of laboratory findings. Obstet Gynecol. 1982 Feb;59(2):153–157. [PubMed] [Google Scholar]

Articles from Transactions of the American Ophthalmological Society are provided here courtesy of American Ophthalmological Society

RESOURCES