What is the earliest ocular manifestation of pregnancy induced hypeension?

Fundus changes in Pregnancy Induced Hypeension (Clinical Manifestations in PIH) The clinical course of fundus changes in PIH may be divided into three stages: (i) Spastic stage: Characterised by spasm of retinal aerioles. (ii) The stage of sclerosis: When pregnancy induced hypeensive changes are superimposed on pre-existing organic sclerotic changes in the vessels. (iii) The stage of retinopathy: Characterised by cotton wool spots, micro aneurysms, flame shaped and splinter haemorrhages, hard exudates, disc edema etc. The first change observed in normal retinal aerioles is constriction of the lumen of superior nasal aerioles.