Purtscher-like retinopathy in a patient with HELLP syndrome

Am J Ophthalmol. 2007 May;143(5):886-7. doi: 10.1016/j.ajo.2006.12.005.

Abstract

Purpose: To report the antepartum presentation of Purtscher-like retinopathy and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome that resulted in severe permanent visual loss.

Design: Interventional case report.

Methods: A 25-year-old primigravida patient at 38.5 weeks gestation presented with severe bilateral loss of vision. Immediate hospitalization with complete evaluation, urgent medical treatment, and cesarean section was performed.

Results: Ophthalmoscopic evaluation showed bilateral Purtscher-like retinopathy. Laboratory studies revealed elevated liver enzymes, thrombocytopenia, and evidence of intravascular coagulation consistent with HELLP syndrome. Despite the successful delivery of a healthy baby, the patient developed permanent visual loss.

Conclusion: Purtscher-like retinopathy with permanent visual loss can occur antepartum in patients with HELLP syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Blindness / enzymology
  • Blindness / etiology*
  • Cesarean Section
  • Disseminated Intravascular Coagulation / diagnosis
  • Disseminated Intravascular Coagulation / etiology
  • Female
  • Gestational Age
  • HELLP Syndrome*
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Liver / enzymology
  • Partial Thromboplastin Time
  • Platelet Count
  • Pregnancy
  • Retinal Diseases / enzymology
  • Retinal Diseases / etiology*
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / etiology

Substances

  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Alanine Transaminase