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This abstract is assigned to session Poster session in O'Bistro
Presentation typeOB - poster
TitleAcute choroidal ischemia as a result of pre-eclampsia associated with PRES and HELLP syndromes: a clinical case.
PurposeTo describe the case of a patient who developed choroidal ischemia and retinal detachment as late manifestation of eclampsia associated in post-partum time with mild PRES (Posterior Reversible Encephalopathy Syndrome) and severe, prolonged HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low Platelets).
MethodsReview of a clinical case.
ResultsAfter an early delivery at 35 weeks caused by pre-eclampsia, the patient developed a severe eclampsia associated with HELLP syndrome. Despite subjective bilateral decreased vision, the ophthalmological examination at the intensive care unit was unremarkable. The brain MRI showed left parietal PRE Syndrome. Six days later, bilateral macular oedema was confirmed by fundus examination. Parietal lesions improved on MR imaging but bilateral choroidal thickening appeared associated with visual acuity of 0.1 RE and 0.2 LE. Fluorescein angiography and OCT confirmed both choroidal ischemia and serous neuroretinal macular detachment. The patient was treated with 1g IV methylprednisolone, 30 mg nifedipine and 500 mg acetazolamide 3 times per day for eight days. Visual acuity progressively improved while the corticosteroids were tapered for four weeks. Six months later, ocular examination confirmed almost full functional recovery.
ConclusionVisual loss due to choroidal ischemia might be a late complication of eclampsia and HELLP syndrome. Visual recovery is usually complete with a prompt management of the aetiology. As corticosteroids and acetazolamide have been recommended in the literature, our case showed an almost complete recovery of visual function.
Author 1
Last nameDELAHAUT
InitialsA
DepartmentUniversité Catholique de Louvain
CityBrussels
Author 2
Last nameVERTES
InitialsD
DepartmentUniversité Catholique de Louvain
CityBrussels
Author 3
Last nameBOSCHI
InitialsA
DepartmentUniversité Catholique de Louvain
CityBrussels
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