Diagnosis of serous neuroretinal detachments of the macula in severe preeclamptic patients with optical coherence tomography.
OBJECTIVE
Visual symptoms are common in patients with preeclampsia, and are caused by various underlying pathological changes in the retina. Blurred vision may be one of these symptoms. We describe three cases in which the underlying retinal pathology of blurred vision was clarified using optical coherence tomography (OCT), a novel, non-invasive ophthalmic imaging technique that provides micrometer-scale resolution images of the human retina.


METHODS
Three patients with preeclampsia complained of blurred vision postpartum. In all cases, ophthalmoscopy was performed at the bedside, followed by the assessment of best corrected visual acuity, slit-lamp biomicroscopy, fluorescein angiography (FLA), and OCT. In all cases, the presence of central visual defects was examined by an Amsler-grid.


RESULTS
In one case, the symptoms were bilateral. In all affected eyes, the patients complained of a relative central scotoma. Ophthalmoscopy showed edema in the affected maculae, while OCT examination clarified a serous neurosensory detachment of the macula. In one case, a neurosensory detachment was also detected in the papillomacular region of a fellow eye with no symptoms. In two cases, FLA was performed, but only in one case could we detect late leakage and subretinal exudates. The serous detachments observed showed total resolution in all cases within 5 to 10 weeks, with restoration of visual acuity.


CONCLUSIONS
In patients with preeclampsia, OCT may provide a useful method for the precise assessment of retinal changes, distinguishing retinal edema from serous neurosensory detachments. This finding may help to clarify the pathophysiological circulatory changes seen in preeclampsia.
Somfai
Gábor Márk
GM
2nd Department of Ophthalmology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary. somfaigm@szem2.sote.hu
Miháltz
Kata
K
Tulassay
Eszter
E
Rigó
János
J
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D019095:Point-of-Care Systems; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000473:pathology*; D011247:Pregnancy; D012164:Retinal Diseases / Q000175:diagnosis* / Q000473:pathology; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence / Q000379:methods