Exudative Retinal Detachment in Preeclampsia. Case Reports

English version

Autoři: Vladimír Kováč ¹; Michaela Leštachová Viková ¹; Petra Bačová ¹; Jana Štefaničková ^2,3; Mária Praženicová ¹; Ladislav Jančo ¹
Působiště autorů: II. Clinic of Ophthalmology SZU, FNsP F. D. R. Banská Bystrica, Slovakia ¹; Clinic of Ophthalmology LFUK a UN Bratislava, Slovakia ²; Oftalmocentrum Betliarska Euromedix, Bratislava, Slovakia ³
Vyšlo v časopise: Čes. a slov. Oftal., 81, 2025, No. Ahead of Print, p. 1-6
Kategorie: Kazuistika
doi: https://doi.org/10.31348/2025/34

Souhrn

Preeclampsia, eclampsia and HELLP syndrome are serious pregnancy-related complications associated with significant morbidity and mortality. These pathological conditions are related to placental dysfunction, systemic endothelial dysfunction and various clinical and biochemical abnormalities. Exudative retinal detachment as a rare but clinically significant ophthalmologic complication of preeclampsia occurs in 0.2–2% of cases, more frequently affecting primigravidas and often presenting bilaterally. This article presents two case reports of patients with preeclampsia complicated by exudative retinal detachment. The first case describes a 22-year-old primigravida at 35 weeks of gestation with preeclampsia, bilateral visual impairment and exudative retinal detachment. The second case involves a 38-year-old primigravida at 31 weeks of gestation with preeclampsia and incompletely expressed HELLP syndrome, in whom visual impairment and unilateral exudative retinal detachment developed after delivery. In both patients, the exudative retinal detachment was resolved and visual acuity improved within a month after delivery and with stabilization of blood pressure.

Klíčová slova:

Preeclampsia – HELLP syndrome – exudative retinal detachment – visual complications of pregnancy

Zdroje

Perloff D. Hypertension and pregnancy-related hypertension. Cardiol Clin. 1998; 16 : 79-101. doi: 10.1016/s0733-8651(05)70386-6
Al-Jameil N, Khan FA, Khan MF, Tabassum H. A Brief Overview of Preeclampsia. J Clin Med Res. 2014 Feb; 6(1):1-7. doi: 10.4021/jocmr1682w
American College of Obstetricians and Gynecologists (ACOG). Hypertension in pregnancy. Obstet Gynecol. 2013;122(5):1122-1131. doi: 10.1097/01.AOG.0000437382.03963.88
Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: Clinical issues and management. A review. BMC Pregnancy Childbirth. 2009; 9 : 8. doi.org/10.1186/1471-2393-9-8
Magee LA, Smith GN, Bloch Ch, et al. Guideline No. 426: Hypertensive Disorders of Pregnancy: Diagnosis, Prediction, Prevention, and Management. J Obstet Gynaecol Can. 2022 May;44(5):547 -⁠ 571. doi: 10.1016/j.jogc.2022.03.002
Tranquilli AL, Dekker G, Magee L, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens. 2014;4(2), 97-104. doi: 10.1016/j.preghy.2014.02.001
Cunningham FG, et al. Williams Obstetrics. 25th edition. (United States of America) McGraw-Hill Education; 2018.
Hayreh SS. Pathogenesis of visual field defects in hypertensive choroidopathy: Experimental study. Arch Ophthalmol. 2011; 129(6):812-819.
Khallouli A, Choura R, Saidane R, et al. Bilateral exudative retinal detachment in HELLP syndrome, first description in North Africa: A case report. PAMJ 2021, 39, 6 doi:10.11604/pamj-cm.2021.6.39.25913
Garcia PV, Ortega-Paz L. Retinal Detachment in association with pre-eclampsia, eclampsia, and HELLP syndrome. Int J Gynaecol Obstet. 2011 Sep; 114(3); 223-225. doi: 10.1016/j.ijgo.2011.04.003
Song YA, Kinouchi R, Ishiko S, Fukui K, Yoshida A. Hypertensive choroidopathy with eclampsia viewed on spectral-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2013;251;2647-2650. doi: 10.1007/s00417-013-2462-9
Querques L, Querques G, Loperfido F, Lattanzio R, BandelloF. Enhanced depth imaging optical coherence tomography findings associated with serous retinal detachment in preeclampsia. Arch Gynecol Obstet. 2014;289;457-459. doi: 10.1007/s00404-013-2966-x
Phipps EA, Thadhani R, Benzing T et al. Preeclampsia: pathogenesis, novel diagnostics and therapies. Nature rev Nephrol. 2019; 15 : 275-289. doi: 10.1038/s41581-019-0119-6
Benlghazi A, Bouhtouri Y, Belouad M, et al. Bilateral serous retinal detachment in pre-eclampsia a rare but favorable complication: case report. Oxf Med Case Reports. 2023 Oct 23;2023(10):omad109. doi: 10.1093/omcr/omad109
Chen KH, Chen LR. Bilateral retinal detachment with subsequent blindness in a pregnant woman with severe pre-eclampsia. Taiwan J Obstet Gynecol. 2013; 52 : 142-144. doi: 10.1016/j.tjog.2012.05.001
Lee CS, Choi EY, Lee M, Kim H, Chung H. Serous retinal detachment in preeclampsia and malignant hypertension. Eye (Lond). 2019 Nov;33(11):1707-1714. doi: 10.1038/s41433-019-0461-8
Munsell MK, Carducci NM, Eton EA. Exudative Retinal Detachment and Ciliochoroidal Effusion in Preeclampsia. J Vitreoretin Dis. 2023 Feb 17;7(3):254-258. doi: 10.1177/24741264221147986
Ledesma-Gil G, Smith RT. Comment on: „Serous retinal detachment in preeclampsia and malignant hypertension“. Eye (Lond). 2019 Nov;33(11):1818. doi: 10.1038/s41433-019-0514-z
Dekker GA, Robillard PY. Preeclampsia-an immune disease? An epidemiologic narrative. Explor Immunol. 2021; 1 : 325-340. doi. org/10.37349/ei.2021.00022
Geldenhuys J, Rossouw TM, Lombaard HA, Ehlers MM, Kock MM. Disruption in the Regulation of Immune Responses in the Placental Subtype of Preeclampsia. Front. Immunol. 2018; 9;1659. doi: 10.3389/fimmu.2018.01659