国际眼科纵览 ›› 2022, Vol. 46 ›› Issue (4): 351-355.doi: 10.3760/cma.j.issn.1673-5803.2022.04.012

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妊娠期高血压疾病眼底病变的研究进展

魏丹  苏九妹  高军   

  1. 天津市第三中心医院眼科  天津市重症疾病体外生命支持重点实验室  天津市人工细胞工程技术研究中心  天津市肝胆疾病研究所 300170

  • 收稿日期:2021-10-29 出版日期:2022-08-22 发布日期:2022-08-22
  • 通讯作者: 魏丹,Email:weidan0351@126.com

Research progress of fundus lesions in hypertensive disorder complicating pregnancy

Wei Dan, Su Jiumei, Gao Jun   

  1. Department of Ophthalmology, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China

  • Received:2021-10-29 Online:2022-08-22 Published:2022-08-22
  • Contact: Wei Dan, Email: weidan0351@126.com

摘要: 妊娠期高血压疾病(hypertensive disorder complicating pregnancy,HDCP)是产科常见的严重并发症。全身小血管痉挛、血管内皮损伤及局部缺血是其基本病理生理变化,进而引起视网膜缺血、缺氧,血管通透性增高而发生HDCP眼底病变,出现视网膜水肿、出血及视网膜脱离等。HDCP眼底病变分为动脉痉挛期、动脉硬化期和视网膜病变期。除眼底像外,OCT可见视网膜厚度及其他结构变化,如多发性浅层视网膜脱离、视网膜外侧高反射亮点、Elschnig斑及脉络膜厚度的改变等。HDCP患者出现眼底病变及与眼底病变严重程度相关的影响因素有血压、血清白蛋白、蛋白尿及尿酸等。出现眼底病变的HDCP患者,低体重儿(<2.5 kg)出生的发生率增加,但其对早产儿视网膜病变的影响尚无定论。(国际眼科纵览,2022, 46:351-355)


关键词: 妊娠期高血压疾病, 眼底病变

Abstract: Hypertensive disorder complicating pregnancy (HDCP) is a common serious complication in obstetrics. Systemic small vessel spasm, vessel endothelial injury and ischemia are the basic pathophysiological changes, which in turn cause retinal ischemia, hypoxia, increased vascular permeability, and HDCP fundus lesions (retinal edema, hemorrhage, and retinal detachment, etc.). HDCP fundus lesions are divided into arterial spasm stage, arteriosclerosis stage and retinopathy stage. In addition to the fundus photographs, OCT can detect changes in retinal thickness and other structure, such as multiple superficial retinal detachment, high-reflection bright spots on the outside of the retina, Elschnig spots, and the thickness changes of the choroid etc. Fundus lesions in HDCP patients and the influencing factors related to the severity of fundus lesions include blood pressure, serum albumin, proteinuria and uric acid. In HDCP patients with fundus lesions, the incidence of low birth weight infants (<2.5 kg) is increased, but its effect on retinopathy of prematurity remains inconclusive.(Int Rev Ophthalmol, 2022, 46:  351-355)

Key words: hypertensive disorder complicating pregnancy, fundus disease