Bilateral Purtscher-Like Retinopathy With Profound Macular Ischemia and Vision Loss in Severe Pre-Eclampsia

Abstract

Purtscher-like retinopathy is an extremely rare condition in patients with pre-eclampsia. The bilateral vision loss as seen in the current case is infrequent, but devastating. Our patient is a 27-year-old healthy primigravida patient with severe pre-eclampsia undergoing uncomplicated cesarean section due to abnormal kidney function and worsening hypertension. Postoperatively, she developed Purtscher-like retinopathy with profound macular ischemia and count-finger only vision. Neuroimaging was unrevealing. Her postoperative course was significant for hyponatremia, acute kidney injury, ileus, pancreatitis, leukocytosis, and postoperative fevers with suspected septic pelvic thrombophlebitis. The resultant visual acuity overall improved, but remained limited to 20/150 and 20/250 at 3 months postpartum. Purtscher-like retinopathy in the setting of pre-eclampsia can result in vision loss even in the absence of findings on neuroimaging or presence of HELLP syndrome. J Clin Gynecol Obstet. 2016;5(3):97-99 doi: http://dx.doi.org/10.14740/jcgo410w