Purtscher-like retinopathy in a patient with HELLP syndrome.
OBJECTIVE
To report the antepartum presentation of Purtscher-like retinopathy and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome that resulted in severe permanent visual loss.


METHODS
Interventional case report.


METHODS
A 25-year-old primigravida patient at 38.5 weeks gestation presented with severe bilateral loss of vision. Immediate hospitalization with complete evaluation, urgent medical treatment, and cesarean section was performed.


RESULTS
Ophthalmoscopic evaluation showed bilateral Purtscher-like retinopathy. Laboratory studies revealed elevated liver enzymes, thrombocytopenia, and evidence of intravascular coagulation consistent with HELLP syndrome. Despite the successful delivery of a healthy baby, the patient developed permanent visual loss.


CONCLUSIONS
Purtscher-like retinopathy with permanent visual loss can occur antepartum in patients with HELLP syndrome.
Stewart
Michael W
MW
Department of Ophthalmology, Mayo Clinic College of Medicine, Jacksonville, Florida 32224, USA. stewart.michael@mayo.edu
Brazis
Paul W
PW
Guier
Christian P
CP
Thota
Sindhu H
SH
Wilson
Shirley D
SD
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001766:Blindness / Q000201:enzymology / Q000209:etiology*; D002585:Cesarean Section; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000201:enzymology; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011247:Pregnancy; D012164:Retinal Diseases / Q000201:enzymology / Q000209:etiology*; D013921:Thrombocytopenia / Q000175:diagnosis / Q000209:etiology
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase