Retinal Detachment in Preeclampsia

Prado, Renata Silva do; Figueiredo, Estêvão Lanna; Magalhães, Télcia Vasconcelos Barros

doi:10.1590/s0066-782x2002001100011

Cited by 28 publications

(28 citation statements)

References 1 publication

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“…This reduction promotes leakage of fluid from the intravascular compartment into the surrounding interstitium and, theoretically, can lead to a pathological accumulation of fluid in the subretinal space or pleural space. Retinal detachment is a rare complication of preeclampsia, observed in 1% to 2% of the patients with severe preeclampsia [18]. The exact pathophysiology of retinal detachment is not well known; however, choroidal ischemia secondary to accelerated hypertension has been proposed as a cause of preeclampsia [19].…”

Section: Discussionmentioning

confidence: 99%

Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia?

Kim

Jung

et al. 2017

Obstet Gynecol Sci

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ObjectiveThe aim of this study was to investigate whether massive proteinuria in preeclampsia is associated with maternal and fetal complications.MethodsWe retrospectively analyzed the clinical records of 233 patients who were diagnosed with preeclampsia. We divided the preeclamptic patients into three groups based on the amount of proteinuria: massive (≥5 g/24 hr), moderate (2 to 5 g/24 hr) and mild (<2 g/24 hr) proteinuria group. We analyzed the clinical characteristics and maternal and neonatal complications among three groups.ResultsGestational age at diagnosis and delivery were lower in women with massive and moderate proteinuria group than women with mild proteinuria group (31.5±3.1 vs. 32.3±3.6 vs. 34.0±3.5 weeks, P<0.001 for gestational weeks at diagnosis; 34.6±3.6 vs. 35.1±4.1 vs. 36.9±4.0 weeks, P=0.001 for gestational age at delivery). In maternal complications, the incidences of pleural effusion and retinal detachment were significantly different among three groups (29.9% vs. 22.4% vs. 9.0%, P=0.004 for pleural effusion; 11.5% vs. 3.0% vs. 1.3%, P=0.009 for retinal detachment). Creatinine levels were higher and albumin levels were lower in the massive proteinuria group than in the moderate and mild groups. However, other maternal and neonatal complications were not significantly different among three groups.ConclusionMassive proteinuria might be associated with renal albumin excretion-related morbidity, such as pleural effusion, retinal detachment, and low serum albumin levels. Furthermore, it was associated with early-onset preeclampsia and early delivery.

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Section: Discussionmentioning

confidence: 99%

Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia?

Kim

Jung

et al. 2017

Obstet Gynecol Sci

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“…The majority of patients have spontaneous reattachment with complete recovery of vision with clinical management. 6,18 Vascular changes in optic nerve may lead to papilledema, acute ischemic optic neuropathy and optic atrophy. Cortical blindness resulting from cerebral vasospasm is a rare complication of PIH.…”

Section: Pregnancy Induced Hypertensionmentioning

confidence: 99%

Pregnancy Induced Ocular Changes and Associated Risk of Ocular Medications

Kaur

Isac

Thomas

et al. 2015

Nepal j. obstet. gynaecol.

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Pregnancy is associated with various ocular changes which can be either physiological or pathological or modification in pre existing conditions. These changes are mostly transient, however some can become permanent. Physiological ocular changes include change in ocular adnexa, tear film composition, cornea, refraction and intraocular pressure. Pathological ocular changes occur as a result of pregnancy induced hypertension, pseudotumour cerebri, vascular occlusive disorders and amniotic fluid embolism. Some of the pre-existing ocular conditions worsen during pregnancy which include diabetic retinopathy, Grave's disease, toxoplasmosis, pituitary tumours, meningioma and uveal tumours. Others show improvement in pregnancy such as uveitis, optic neuritis and multiple sclerosis. Yet others are associated with exacerbations during postpartum period as optic neuritis. Knowledge of these changes is important for both ophthalmologists and gynaecologists for proper management of these patients. Also the treatment modalities for various disorders differ between pregnant and non pregnant females. The ophthalmic medications should be used cautiously during pregnancy and lactation to avoid harmful effects in the mother and the fetus. The materials published in Pubmed, Google Scholar webpages and standard books have been used for preparing this paper.

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“…Although the visual system may be affected in 30-100% of patients with preeclampsia, serous retinal detachment is an unusual cause of visual loss, occurring in 51% of preeclamptic patients [3]. It is, however, a known complication of TTP with hypertension believed to be a contributing factor.…”

mentioning

confidence: 99%

“…Permanent blindness from SRD is rare. The current reported rate of SRD in severe preeclampsia is 0.2-2% [3]. In contrast, 14-20% of TTP patients have ocular involvement [7].…”

mentioning

confidence: 99%

Bilateral retinal detachments and preeclampsia: thrombotic thrombocytopenic purpura or syndrome of haemolysis, elevated liver enzymes, low platelets?

Mendez‐Figueroa

Davidson

2010

The Journal of Maternal-Fetal & Neonatal Medicine

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Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening disorder that rarely affects pregnancy. In contrast, preeclampsia is an obstetric complication encountered much more frequently in clinical practice. A recent review of pregnancy associated TTP in 166 pregnancies revealed a mortality of 26% with initial TTP in pregnancy, which increased to 44.4% with concurrent preeclampsia [1]. The syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP) complicates approximately 4-12% of patients with severe preeclampsia [2] and can present clinically in much the same way as TTP, thus delaying the correct diagnosis and management. Martin et al.[1] were able to identify characteristic laboratory findings observed with TTP alone and when TTP co-exists with preeclampsia and HELLP syndrome.Serous retinal detachments (SRD) are a rare complication in pregnant women with preeclampsia. Although the visual system may be affected in 30-100% of patients with preeclampsia, serous retinal detachment is an unusual cause of visual loss, occurring in 51% of preeclamptic patients [3]. It is, however, a known complication of TTP with hypertension believed to be a contributing factor.The present report illustrates a case of a patient presenting to labour and delivery with severe preeclampsia that was initially complicated with bilateral retinal detachments. She later developed HELLP syndrome and was ultimately diagnosed with underlying TTP. She had a marked improvement of her lab values and her clinical course once plasmapharesis was initiated.

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Retinal Detachment in Preeclampsia

Cited by 28 publications

References 1 publication

Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia?

Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia?

Pregnancy Induced Ocular Changes and Associated Risk of Ocular Medications

Bilateral retinal detachments and preeclampsia: thrombotic thrombocytopenic purpura or syndrome of haemolysis, elevated liver enzymes, low platelets?

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