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Int J Gynaecol Obstet · Sep 2011
Review Case ReportsRetinal detachment in association with pre-eclampsia, eclampsia, and HELLP syndrome.
- Paulino Vigil-De Gracia and Luis Ortega-Paz.
- Critical Care Unit, Department of Obstetrics and Gynecology, Caja de Seguro Social, Panama, Panama. pvigild@hotmail.com
- Int J Gynaecol Obstet. 2011 Sep 1; 114 (3): 223-5.
ObjectiveTo review case reports of retinal detachment in women with pre-eclampsia/eclampsia.MethodsMedline was searched for case reports of retinal detachment associated with pre-eclampsia/eclampsia. Articles written in English, Spanish, or Portuguese and published between 1990 and 2010 were reviewed.ResultsA total of 28 cases of retinal detachment were identified; 15 were associated with severe pre-eclampsia (3 of these probably had hemolysis, elevated liver enzymes, and low platelets [HELLP] syndrome), 9 with HELLP syndrome, 2 with eclampsia, and 2 with both HELLP syndrome and eclampsia. The majority (60%) of women were nulliparous, 4 had abruptio placentae, and cesarean delivery was performed in 76%. Retinal detachment was bilateral in 89% and associated with delivery of the fetus in 96%; 69% were diagnosed postpartum. Within 2-12 weeks postpartum, all patients had complete recovery of vision with clinical management.ConclusionRetinal detachment in pre-eclampsia/eclampsia might be associated with HELLP syndrome, indicating that microangiophatic hemolysis might have a role in the pathophysiology of retinal detachment. Its occurrence might not be correlated with the severity of pre-eclampsia because pre-eclampsia is a constellation of signs and symptoms (persistent vasospasms with hemolysis and hypoalbuminemia) rather than simply being hypertension.Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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