[Retinochoroidal changes in toxemia of pregnancy with the relation to hypertensive retinopathy and choroidopathy].

Thirty patients who suffered from ocular involvement caused by toxemia of pregnancy were examined ophthalmologically during the nine-year period between 1980 and 1988 at Osaka Medical Center and Research Institute for Maternal and Child Health. The ophthalmoscopic findings were divided into the following five categories: cotton wool patches (CWP), retinal hemorrhages (RH), hard exudates (HE), yellowish opaque foci (YOF) and serous retinal detachments (SRD). Although the first three types of findings were recognized as hypertensive retinopathy (Keith-Wagener III or IV), the last two were recognized as choroidal vascular damage. Based on the frequency of fundus findings, patients were divided into three types: R-type mainly suffered from retinal vascular occlusion (CWP), C-type mainly suffered from choroidal vascular occlusion (YOF, SRD), and R + C-type consisted of mixed vascular occlusion. The maximum systolic blood pressure of C-type patients was significantly lower than that of R-type. The maximum diastolic blood pressure of C-type patients was also significantly lower than those of R-type and R + C-type. There were five C-type cases with systolic blood pressure of less than 160 mmHg in which the choroidal ischemia was concluded not to be hypertensive choroidopathy but a specific alteration characterized by toxemia of pregnancy (hypercoagulopathy).