INFORMATION FOR WOMEN WHO HAVE RETINAL DISEASE DURING PREGNANCY OR BREASTFEEDING

What is retinal disease during pregnancy?

Retinal diseases include any condition that involves the retina, the part of the eye, where optical information is converted into nerve signals that lead to image formation in the brain. Such conditions can result from genetic conditions, injuries, and chronic diseases and processes that have effects throughout the body, including in the eyes over periods of time much longer than the duration of pregnancy. However, certain retinal conditions are pregnancy-associated in the sense that changes in hormones, immunological function, metabolism, and blood circulation can exacerbate, trigger, or alter the retinal effects. Of the retinal conditions that pregnancy can affect, diabetic retinopathy (DR), a condition resulting from damage to the blood vessels that supply the retina, is the most common. Pregnancy also can trigger hypertensive retinopathy (high blood pressure causing retina disease by harming retinal blood vessels), retinal detachment (due to high blood pressure), and less common retinal conditions, such as idiopathic central serous chorioretinopathy (ICSC), retinal artery occlusion, and retinal vein occlusion. In the case of retinal problems caused by high blood pressure, this can happen in women with gestational hypertension, but also additional problems, namely preeclampsia, eclampsia, and HELLP syndrome. In its worse form, HELLP syndrome includes a clotting and bleeding complication called disseminated intravascular coagulopathy (DIC), which also can damage the retina. Women who are pregnant, or delivered recently, comprise a large portion of patients with another bleeding disorder called thrombotic thrombocytopenic purpura (TTP), which can cause retinal damage as well. Additionally, the retina can be damaged by a complication called amniotic fluid embolism (AFE), but AFE is rare and often is fatal, so it’s not a major contributor to retinal disease in pregnancy.