Choroidal Morphology in a Patient With Hellp Syndrome

Kasai, Ayaka; Sugano, Yukinori; Maruko, Ichiro; Sekiryu, Tetsuju

doi:10.1097/icb.0000000000000249

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Preeclampsia affects approximately 3% to 5% of pregnancies and is defined as blood pressure of 140/90 mm Hg or greater after 20 weeks of gestation with proteinuria. 4 In addition to exudative retinal detachment, preeclampsia can lead to several other ocular and visual pathway manifestations including hypertensive retinopathy, 5 retinal arteriolar spasm, 4 cotton-wool spots, 5 macular edema, 6 retinal pigment epithelial (RPE) infarction and necrosis, 7 retinal hemorrhages, 5 posterior reversible encephalopathy syndrome, 8 anterior ischemic optic neuropathy, 9 and even cortical blindness. 9 Exudative retinal detachments affect approximately 0.2% to 2.0% of patients with preeclampsia and 0.9% of patients with HELLP syndrome.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome

Govindaraju

Schimmel

Trese

et al. 2022

Journal of VitreoRetinal Diseases

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Purpose: We present a complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome including bilateral exudative retinal detachments, bullous chemosis, and impaired ocular motility. Methods: The patient was followed in the inpatient and outpatient setting with clinical examinations, optical coherence tomography, widefield fundus photography, neuroimaging including magnetic resonance imaging of the brain/orbits, as well as carotid artery ultrasonography. Results: Our patient was admitted with bilateral vision changes in the setting of preeclampsia and HELLP syndrome and was found to have bilateral exudative detachments, retinal exudation, severe bullous chemosis, and impaired motility. She was started on intravenous dexamethasone followed by an extended prednisone taper with resolution of her ocular findings and return of her vision to baseline. Conclusions: There is evidence that HELLP syndrome and preeclampsia are proinflammatory syndromes. Aggressive blood pressure control, corticosteroids, and a multidisciplinary approach might accelerate visual and systemic recovery in these complex cases.

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Section: Discussionmentioning

confidence: 99%

Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome

Govindaraju

Schimmel

Trese

et al. 2022

Journal of VitreoRetinal Diseases

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“…HELLP syndrome represents a severe form of preeclampsia [ 6 ]; however, the diagnosis of HELLP syndrome can be made without underlying preeclampsia [ 7 ]. Subjective visual symptoms are reported by approximately 40% of preeclamptic patients but blindness is rare.…”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiology of HELLP syndrome is believed to be similar to that of disseminated intravascular coagulation (DIC). Thus, microthrombi that are formed disrupt choroidal circulation [ 7 ]. The additional combination of arterial hypertension and nephropathy contributes to aggravate this situation [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Exudative Retinal Detachment Complicating Preeclampsia With Partial Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome

Zebbache¹

2021

Cureus

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Serous retinal detachment is an uncommon complication of pregnancy that occurs in well-known situations, such as severe preeclampsia, eclampsia, or hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. The latter still does not reach a consensus, in particular on its classification and pathophysiology. We report the case of a young pregnant woman having a partial HELLP syndrome with massive proteinuria who presented a bilateral exudative retinal detachment having healed spontaneously after pregnancy termination and blood pressure control without requiring an ophthalmologic intervention.

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Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review

Janoudi¹,

Uzun²,

Boyd³

et al. 2023

IJWH

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Background Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity. The management of preeclampsia has not changed much in more than two decades, and its aetiology is still not fully understood. Case reports and case series have traditionally been used to communicate new knowledge about existing conditions. Whether this is true for preeclampsia is not known. Objective To determine whether recent case reports or case series have generated new knowledge and clinical discoveries about preeclampsia. Methods A detailed search strategy was developed in consultation with a medical librarian. Two bibliographic databases were searched through Ovid: Embase and MEDLINE. We selected case reports or case series published between 2015 and 2020, comprising pregnant persons diagnosed with hypertensive disorders of pregnancy, including preeclampsia. Two reviewers independently screened all publications. One reviewer extracted data from included studies, while another conducted a quality check of extracted data. We developed a codebook to guide our data extraction and outcomes assessment. The quality of each report was determined based on Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series. Results We included 104 case reports and three case series, together comprising 118 pregnancies. A severe presentation or complication of preeclampsia was reported in 81% of pregnancies, and 84% had a positive maternal outcome, free of death or persistent complications. Only 8% of the case reports were deemed to be of high quality, and 53.8% of moderate quality; none of the case series were of high quality. A total of 26 of the 107 publications (24.3%) included a novel clinical discovery as a central theme. Conclusion Over two-thirds of recent case reports and case series about preeclampsia do not appear to present new knowledge or discoveries about preeclampsia, and most are of low quality.

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Choroidal Morphology in a Patient With Hellp Syndrome

Cited by 3 publications

References 28 publications

Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome

Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome

Bilateral Exudative Retinal Detachment Complicating Preeclampsia With Partial Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome

Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review

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