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Review ofLiterature
It is an indicator of disease severity and its presence is associated
with substantial increase in the perinatal mortality rate (Naeye and
Friedman, 1979).
Davery and MacGilIiveray (1987) have suggested that proteinuria
should be classified as severe if there are 2:: 3gm protein in a 24hr
collection.
The clinically oriented classification of the American Committee
on Classification does not require proteinuria for the diagnosis of
preeclampsia because it is usually of late onset in the course of the
disease that the onest of convulsions may precede its appearance
(Chesley and Sabiai, 1988).
Retinal changes and ocular manifestations:
Retinal vasoconstriction is the most obvious fourth sign in manifest
preeclampsia, along with the classic symptom triad of hypertension,
edema and proteinuria. The tonic constriction of retinal arteries may
appear like a corkscrew. (Hollwich, 1979).
Beside the narrowing of the vessels there is a slight edema of the
posterior pole of the retina and the disc shows a slight lack ofdefinition
of its margins. Cotton • wool exudate, retinal stria, and yellow - white
focal retinal lesions may develop (Fastenderg et al., 1980)
If the pregnancy is not terminated, the retinal edema may progress
to flat detachment of the retina. The incidence of serious retinal
detachment is about 1.2 per cent in preeclampsia and about IDA per cent
in eclampsia (Fry, 1929).
Bosco (1961) reported that retinal detachment is usally bilateral
and frequently affects the lower portion of the retina and that it resolves
spontaneously in the majority of cases within 2 weeks of labor.
31