Andrologia e Ginecologia: Pesquisa Atual

A case of bilateral retinal detachment in a pregnant patient with severe preeclampsia

Maria Maricar A Manuel

Introduction: Preeclampsia is classified as a hypertensive disorder in pregnancy, which occurs in the absence of other causes of elevated blood pressure and in combination with generalized edema, proteinuria or both. Preeclampsia is an obstetric disease of unknown cause that affects approximately 5% of pregnant women. It is a systemic disorder that can affect almost every organ in the body. The visual system may be affected with variable intensity, being the retinal detachment a rare complication. The retinal detachment in preeclampsia is usually bilateral and serous, and its pathogenesis is related to the choroidal ischemia secondary to an intense arteriolar vasospasm. Exudative retinal detachment is an unusual cause of visual loss in Preeclampsia. The visual system may be affected with variable intensity, being the retinal detachment a rare complication. The majority of patients have complete recovery of vision with clinical management, and surgery is unnecessary. This reports a case of bilateral exudative retinal detachment in a 30-year-old woman at term who developed preeclampsia during her first pregnancy and complained of worsening blurring of vision described as vision of being underwater, obscuring her sight.

Case Report: We report a case of 30-year-old Myopic; term Primigravid with severe preeclampsia that developed bilateral exudative retinal detachment at the time of labor. Labor was induced due to low amniotic fluid volume and subsequently reached second stage of labor. She underwent emergency low segment cesarean section-I due to prolonged second stage of labor secondary to cephalopelvic disproportion at the level of the midplane. Preeclampsia, myopia and maternal exhaustion could have been contributed to the development of bilateral retinal detachment in this patient. She was co-managed with ophthalmology retina service was given oral and topical steroids and advised strict blood pressure monitoring and control. Two weeks after delivery, there was spontaneous and complete resolution of the bilateral exudative retinal detachment, with residual pigmentary changes of the retinal pigment epithelium.

Conclusion: The management of retinal detachment as a complication in preeclampsia is conservative and the prognosis is usually good.