Differential Diagnosis for Visual Field Changes in Pregnancy
Single Most Likely Diagnosis
- Preeclampsia: This condition is a leading cause of visual disturbances in pregnancy, including visual field changes, due to its effects on the vascular system and potential for causing posterior reversible encephalopathy syndrome (PRES).
Other Likely Diagnoses
- Migraines: Migraines are common in pregnancy and can cause transient visual field defects, including scintillating scotomas and homonymous hemianopia.
- Pituitary Adenoma: Pituitary adenomas can expand during pregnancy due to hormonal changes, potentially causing chiasmal compression and leading to bitemporal hemianopia.
- Diabetic Retinopathy: Pregnant women with pre-existing diabetes are at risk of worsening diabetic retinopathy, which can lead to visual field changes.
Do Not Miss Diagnoses
- Stroke: Although less common, stroke is a critical diagnosis that must not be missed. Visual field defects can be a presenting symptom of a stroke, and timely intervention is crucial.
- Brain Tumors: Other brain tumors, aside from pituitary adenomas, can cause visual field changes by compressing or invading the visual pathways.
- Venous Sinus Thrombosis: This condition can cause increased intracranial pressure and lead to visual field changes, including papilledema.
Rare Diagnoses
- Choriocarcinoma Metastasis: Rarely, choriocarcinoma, a type of gestational trophoblastic disease, can metastasize to the brain and cause visual field defects.
- Cavernous Sinus Thrombosis: This is a rare condition that can lead to visual field changes among other symptoms, due to its location and potential to affect multiple cranial nerves.
- Idiopathic Intracranial Hypertension (IIH): Also known as pseudotumor cerebri, IIH can cause visual field changes, including peripheral field loss and can be associated with pregnancy.