Retinal detachment in postpartum preeclampsia and eclampsia: report of two cases.
Retinal detachment is an unusual complication of hypertensive disorder in pregnancy. It has been reported in 1% to 2% of patients with severe preeclampsia and in 10% of patients with eclampsia. Choroidal ischemia may be the cause of retinal detachment. We know that mild arteriolar spasm involving the bulbar conjunctival vessels has been observed in the normal pregnancy, but in pregnancy-induced hypertension the vasospasm may be severe and result in choroidal ischemia. Most patients with retinal detachment in pregnancy-induced hypertension have had full spontaneous resolution within a few weeks, and they did not have any sequelae. Medical treatment with antihypertensive drugs and steroids may be helpful. We report two rare cases of retinal detachment and persistent hypertension in association with postpartum eclampsia and post-cesarean section preeclampsia. These patients had normotension throughout pregnancy. Preeclampsia or eclampsia developed after delivery, and blurred vision, headache, and reduced vision accompanied serous retinal detachment. The serous retinal detachment disappeared within 3 weeks. Good outcomes were found in the follow-up examinations in both of these cases. For women who had been normotensive at the time of delivery and then complained in the postpartum period of blurred vision, headaches, nausea and vomiting, we should consider the possibility of retinal detachment and perform fundoscopy.
Lee
C
C
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung, Taipei, Taiwan, R.O.C.
Hsu
T Y
TY
Ou
C Y
CY
Chang
S Y
SY
Soong
Y K
YK
D000328:Adult; D004461:Eclampsia / Q000150:complications*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000150:complications*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000209:etiology* / Q000628:therapy; D012163:Retinal Detachment / Q000209:etiology* / Q000628:therapy