A 38-Year-Old Woman, Gravida 3 Para 2, at 35 Weeks

A 38-year-old woman, gravida 3 para 2, at 35 weeks gestation comes to the emergency department due to sudden-onset visual changes and headache.  The patient reports "spots" in her vision for the past few hours and an occipital headache.  She took a dose of acetaminophen, but it did not improve her symptoms.  The patient's pregnancy has been complicated by gestational diabetes mellitus requiring insulin.  Blood pressure is 168/114 mm Hg and pulse is 90/min.  The pupils are equal and reactive to light.  Extraocular movements are intact.  Visual field testing shows partial loss of vision bilaterally.  Which of the following is the most likely cause of this patient's symptoms?

A) Choroidal neovascularization
B) Decreased anterior chamber angle
C) Hemorrhage into the vitreous humor
D) Inflammatory optic nerve demyelination
E) Retinal artery vasospasm

Correct Answer:

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