Estudo morfofuncional na visão em gestantes atendidas no pré-natal em uma unidade de saúde na capital do Estado do Amapá

Abstract

Gestation comprises a natural state of physiological stress for the body, in which all bodily systems become targets of modifications. The visual system, as one of these systems, also undergoes adaptations, being able to involve optical and/or neural components, affecting the morphological and functional processes in a transient or permanent way. Although the prevalence of ocular complications during gestation are mild, transient and do not require treatment, some are occasionally severe, permanent and require ophthalmologic referrals and may be unnoticed by the pregnant woman. This study aimed to investigate the morphofunctional aspects of the visual system of assisted pregnant women in prenatal care at usual risk and to compare the visual performance of non-pregnant women. This is an epidemiological, cross-sectional, epidemiological study with a quantitative approach. Three steps were taken: screening of pregnant women through anamnesis, determination of visual acuity and Ishihara in step 1, psychophysical assessment for color vision with the Farnsworth D15 and Lanthony D15 test in step 2, and finalized with ophthalmologic clinical evaluation through refractometry, intraocular pressure, retinography and optical coherence tomography in stage 3. For the analysis of stage 1 and 2, the descriptive statistics of these were made for the group of pregnant women. To evaluate the difference in color discrimination between pregnant and non-pregnant women, the Shapiro-Wilk test and the Kruskal-Wallis test were used. For the tomography, normal ranges were determined for the following parameters: foveal thickness, mean fiber thickness of the optic nerve, thickness of the temporal, nasal, upper and lower quadrants of the right and left eyes. The results show that there was no statistical difference in any of the parameters analyzed between the control group and the pregnant women in the three quarters in the Farnsworth D15 test. The third-trimester women had higher C-index and S-index values than the control group (C-index, p = 0.023, S-Index p = 0.027) 0.015; S-Index p = 0.021) on the Lanthony D15 desaturated test. Optical coherence tomography showed that at least 40% of the pregnant women had morphological changes in the retina and optic nerve. Functional analysis showed that there is loss of color vision during the pregnancy culminating in significant loss in the third trimester when compared to first-trimester and non-pregnant women. Mild retinal and optic nerve changes may be responsible for this progressive loss