Increased prevalence of transient visual disturbances with normal ocular exam findings in pregnancy – cross-sectional study

Pregnancy induces significant physiological changes in women, impacting various bodily systems. These alterations can influence ocular health and visual function. Ophthalmologists at our center noted an apparent increase in reports of transient binocular visual disturbances among pregnant women presenting to the Ophthalmic Emergency Room (OER), with no ophthalmic findings. This study aims to examine the rate of Transient Visual Disturbances with Normal Ocular Examination (TraViNo) in pregnant vs. non-pregnant women of childbearing age. A cross-sectional study was conducted at Sheba Medical Center, analyzing data from 562 females between 18 and 50 years of age who presented to the OER during January-March 2019. Data retrieved from the participants' medical records included demographics, medical history, symptoms, comprehensive ophthalmological evaluation findings, and final diagnoses recorded at the OER. Included were 562 females (mean age 31.2 ± 9.0 years), among whom 69 (12.0%) were pregnant (mean pregnancy week 25 ± 11). The mean age was similar for both groups (P = 0.2). Presenting symptoms varied between the groups (P < 0.001), with the most common being visual disturbances in the pregnant group (PG) (58%). TraViNo was the final diagnosis in 86 (15%) study women and significantly more common in the PG (48% vs. 11%, respectively, P < 0.001). Most cases (74%) were bilateral. The additional workup included neurologic examinations in 45 (66%) cases, brain/orbital imaging in 28 (33%), and visual field testing in 8 (12%). Obstetric evaluations performed in the PG were normal except for 2 cases of hypertension. TraViNo is more common during pregnancy. Further research is warranted to identify underlying causes and long-term implications.