A pregnant woman in her 30s presented at 20 weeks with a 4-week history of bilateral decreased vision. Her medical history was remarkable for type 2 diabetes (which was well-controlled with insulin), and a review of systems found that she had not experienced headache, pain, or neurologic complaints. Her blood pressure was 102/54, and her best-corrected visual acuity was 20/50 OD and 20/40 OS without afferent pupillary defect, motility disturbance, or intraocular pressure abnormalities. A fundus examination was remarkable for bilateral hyperemic discs and macular edema and subretinal fluid, with numerous flame-shaped hemorrhages in 4 quadrants without microaneurysms, exudates, or neovascularization (Figure). There was no evidence of intraocular inflammation. Fluorescein angiography was deferred because of her pregnancy.
Zhang AY, Reddy AK. Bilateral Decreased Vision During Pregnancy. JAMA Ophthalmol. 2017;135(7):807–808. doi:10.1001/jamaophthalmol.2016.5453
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