FUNDOSCOPY IN PIH RETINA Mirror to the cardiovascular

FUNDOSCOPY IN PIH RETINA Mirror to the cardiovascular system of the body FUNDOSCOPY Visualization of hypertensive changes PIH Retinal changes run parallel with the severity of hypertension hence that of pre-eclampsia.

PROCEDURE ONE DROP EVERY 10 MINUTES THREE TIMES FUNDOSCOPY AFTER ONE HOUR BEFORE FOUR HOURS

SYSTEMIC HYPERTENSION VASOSPASM VASOSCLEROSIS RETINOPATHY

NORMAL FUNDUS Uniform Caliber Smooth sinuous course Brach at obtuse angle

VASOSPASM NARROWING STRAIGHTENING ACUTE ANGLED BRANCHING A-V RATIO 1: 3

VASOSCLEROSIS SALU’S SIGN Deflection in the course of the vein at the Arterio-venous crossing

VASOSCLEROSIS GUNN’S SIGN Concealment of the vein beneath the artery at the Arterio-venous crossing

RETINOPATHY SOFT EXUDATES RETINAL HEMORRHAGES RETINAL EDEMA HARD EXUDATES RETINAL DETACHMENT

RETINOPATHY SOFT EXUDATES Occulsion of precapillry arteriole Capillary nonperfusion Localised axoplasmic stasis Compact yellowish white fluffy lesions Cotton wool spots

RETINOPATHY FLAME SHAPED HAEMORRGHAGES Fibrinoid necrosis in the vessel wall Located in the Nerve fibre layer of retina Bright red flamed shaped hemorrhage

RETINOPATHY MACULAR STAR HARD EXUDATES Increased capillary Permeability Retinal edema Precipitation of lipids Discrete dense yellow lesions Macular star

RETINAL DETACHMENT LOCALISED RETINAL DETACHMENT Accumulation of Serous fluid between Retinal pigment epithelium and Neurosensory retina

RETINAL DETACHMENT TOTAL BULLOUS DETACHMENT

OPTIC DISC EDEMA MALIGNANT HYPERTENSIVE RETINOPATHY

KEITH-WAGENER-BARKER 1939 FEATURES Narrowing of the retinal arteries A-V CHANGES SALU’S SIGN AND GUNN’S SIGN K-W-R GRADING I II SURVIVAL EXCELLENT GOOD RETINOPATHY SOFT EXUDATES FLAME HAEMORRHAGES HARD EXUDATES III POOR IV VERY POOR RETINAL EDEMA/RETINALDetachment DISC EDEMA

AMERICAN OPHTHALMOLOGICAL SOCEITY K-W-R GRADING I AOA GRADING FEATURES O Normal fundus I II Focal Narrowing Diffuse generalised narrowing II III RETINOPATHY IV IV DISC EDEMA SOFT EXUDATES/FLAME HAEMORRHAGES RETINAL EDEMA/RETINAL DETACHMENT

IMPLICATION FEATURES PREGNANCY NORMAL FUNDUS CONTINUE FOCAL NARROWING DIFFUSE NARROWING RETINOPATHY SOFT EXUDATES FLAME HAEMORRHAGES HARD EXUDATES RETINAL EDEMA/RD DISC EDEMA TERMINATE

FUNDOSCOPY IN PIH CONTINUE TERMINATE

PROGNOSIS