A case of bilateral serous retinal detachments in severe pre-eclampsia

摘要

A healthy 28-year-old nulliparous woman with a dichorionic, diamniotic twin pregnancy following IVF developed mild pre-eclampsia at 28 weeks. At 31 weeks, an uneventful LSCS was performed because of worsening pre-eclampsia. Her postoperative blood pressure readings were between 146-180/92-120 mmHg prompting control with intravenous labetalol.Five hours post-delivery she complained of cloudy visual disturbance with black dots. Examination revealed blurred optic disc margins while retaining normal visual fields. At 24 h postpartum, her visual acuity had reduced to finger counting. Normal MRI and angiography excluded venous thrombosis and ophthalmology review confirmed large areas of bilateral exudative retinal detachment. Expectant management using antihypertensive therapy was advised. This was subsequently discontinued with a complete return to normotension 4 weeks following delivery.Outpatient ophthalmology review 1 week postpartum revealed poor colour vision. Three weeks postpartum her visual acuity hadimproved and the retinal detachments were resolving. The right eye showed an area of retinal pigment epithelial disturbance. At 6 weeks, she had normal visual acuity (left 6/5 and right 6/9).