Point-of-care ultrasonography of the orbit for detection of retinal detachment in a patient with hemolysis, elevated liver enzymes, and low platelet count syndrome

Abstract

Retinal detachment is a rare, but well-known cause of visual impairment in patients with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. With supportive care, patients usually improve, with complete recovery of vision. Bedside ultrasonography of the orbit can be helpful for early detection of retinal detachment in these patients. Here, we present a case of HELLP syndrome presenting with severe visual symptoms. Retinal detachment was detected with point-of-care ocular sonography, which was confirmed with ophthalmoscopic examination. The patient was reassured of the favorable prognosis. Early initiation of aggressive supportive care was followed by progressive improvement of vision, which correlated with sonographic evidence of resolution of detachment. Her vision recovered completely in 2 weeks.

Multimodal Imaging in Hellp-Related Chorioretinopathy

“…These alterations cause increasing vascular permeability and fluid accumulation leading to SRD. 1,2,5,7–11 These Elschnig spots—known as ischemic infarct of RPE and choroid 10 —and SRD were indeed overlying the ischemic choroidal zones seen through the ICG phases, which supports this concept of RPE lesions causing the breakdown of the outer retinal barrier.…”

“…Association between pregnancy-induced hypertension and HELLP syndrome increases the occurrence of SRD seven times. 5 This rare but well described complication affects 1% of women suffering of HELLP syndrome. 6,7 Fig.…”

Ultrasonographic assessment of paediatric ocular emergencies: A tertiary eye hospital based observation

“…Abu-Zidan et al [4] discussed the posterior segment and periocular ultrasound findings in a case of severe posttraumatic eye with externally impinging foreign body. Similarly, other studies [5][6][7] have evaluated the accuracy of ultrasound in detecting acute posterior segment pathologies such as retinal detachment, retinal tear, vitreous hemorrhage and posterior vitreous detachment. An early detection of the above conditions can help in appropriate referral, early management and visual rehabilitation.…”