Pregnancy Associated Retinal Vascular Events: A Three-Case Series

Abstract

Pregnancy induces significant systemic and vascular changes that may acutely affect the eye. Some manifestations threaten vision and require multidisciplinary care.

A descriptive case-series of three pregnant women presenting with acute visual loss who un- derwent comprehensive ophthalmologic and systemic evaluation, including multimodal imaging, in close coordination with obstetric teams.

A case with exudative retinal detachment (ERD): A 28-year-old with severe preeclampsia de- veloped bilateral serous detachments that resolved completely after delivery and systemic stabi- lization.

A case with paracentral acute middle maculopathy (PAMM): A 31-year-old at 12 weeks’ gesta- tion presented with a paracentral scotoma in the right eye (OD). Optical coherence tomography (OCT) showed parafoveal hyperreflectivity. Vision remained 1.0, with residual scotoma and with inner nuclear layer (INL) thinning.

A case with Valsalva retinopathy: A 35-year-old at 37 weeks developed a massive subhyaloid hemorrhage in the left eye (OS). Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser hyaloidotomy enabled rapid visual recovery.

Pregnancy-associated retinal vascular events, though rare, reflect distinct pathophysiologic mechanisms and require prompt recognition, multimodal imaging, and coordinated obstetric- ophthalmologic management for optimal outcomes.