Bilateral retinal detachment in pregnancy complicated by preeclampsia , eclampsia and placental abruption

Abstract

Retinal detachment is an unusual complication of hypertensive disorders of pregnancy. Its incidence is around 1% - 2% in severe preeclampsia and 9-10% of patients in eclampsia. The bulbar conjunctival vessels show severe vasospasm in preeclampsia /eclampsia resulting in choroidal ischemia. This may then lead to retinal detachment which is usually serous in variety. The patient of hypertensive disorder of pregnancy complaining of loss of vision or scotoma should be promptly investigated with a fundoscopy to diagnose the entity. Obstetric management which is advocated is prompt delivery of the fetus which will result in amelioration of symptoms within the next few weeks. Majority of the patients who manifest with retinal detachment during pregnancy respond to clinical conservative management and show complete recovery within weeks and no surgical intervention is needed. Spontaneous full resolution is achieved once the blood pressure comes down to normal and the arteriolar vasospasm gets relieved.