Objective  To analyze the changes in pregnancy-induced hypertension syndrome （PIHS） using optical coherence tomography （OCT）. Methods  A prospective study was conducted to investigate 132 patients （264 eyes） with PHIS who consented to eye examinations that included visual acuity， refraction， slit lamp examination， fundus examination， and OCT. Chi-square tests and Spearman correlation analysis were used to investigate the statistical correlation between retinal detachment seen in OCT exams and patients′ general information （blood pressure， edema， proteinuria）. Results  ①A fundus examination showed that 232 eyes （87.9%） with PHIS had fundus lesions， including stage I in 16 eyes （6.9%）， stage II in 31 eyes （13.4%）， and stage Ⅲ in 185 eyes （79.7%）. ②OCT examination showed that 172 eyes （65.2%） had abnormalities， including neurosensory serous retinal detachment in 94 eyes （54.6%）， pigment epithelium and IS/OS layer changes in 40 eyes （23.3%）， and optic disc edema， retinal hemorrhage and other changes in 38 eyes （22.1%）. ③Since hypertension， edema， and proteinuria are risk factors for retinal detachment， a higher blood pressure leads to more severe proteinuria and edema， which are correlated with a higher risk of retinal detachment （r=0.156， 0.208， 0.296， P<0.05）. Conclusion  As a non-contact， non-invasive tomographic imaging technique for severe PIHS， OCT provides objective and accurate inspection images that detect changes in the fundus.