Bilateral Bullous Retinal Detachment in a Case of Preeclampsia
A 30-year-old caucasian primigravida was diagnosed with arterial hypertension at
34 weeks of gestation. At 36th week, labor induction was performed for severe preeclampsia. During labor, blood pressure was controlled with labetalol and convulsion prophylaxis
was performed with magnesium sulfate.
She had a vaginal delivery without complications and forty-eight hours later complained of intense fronto-occipital headache, blurred vision and metamorphopsia with a sudden decrease in visual acuity. Blood pressure during the postpartum period was 170/110 mm Hg. Blood samples showed no abnormalities.
The previous ocular history was unremarkable. The patient was transferred from a secondary to a tertiary hospital in order to have an adequate ophthalmologic evaluation that revealed visual acuity of 2/10 and 4/10 in the right and left eye, respectively.
Fundoscopy, retinography and Optical Coherence Tomography showed bilateral bullous retinal detachment of the posterior pole with no hemorrhage or retinal exudates and also contributed to exclude the presence of a macular hole in both eyes.
There was no retinal tear on peripheral retina examination. Neurological examination was normal and cranial computed tomography scan showed no lesions.
Blood pressure was controlled with 48 hours of labetalol.
Magnesium sulfate was performed in accordance to the Department´s protocol for the management of severe preeclampsia. Ophtalmologic re-evaluation on days 2 and 4 improved significantly, without specific therapy.
She was discharged asymptomatic on day 7 with controlled blood pressure.
Follow-up examination 2 weeks later showed complete resolution of the retinal detachment.
Visual acuity remained 8/10 for both eyes.
Gynecol Obstet Res Open J . 2014; 1(1): 6-7. doi: 10.17140/GOROJ-1-102