PDF(Pubmed)
Abstract：
We report a case of a 31-year-old gravida 2 para 1 female presenting to the optician with a two-week history of blurred vision and persistent headaches at 29 weeks gestation. Visual acuity on presentation was 6/100 in the right eye and 6/24 in the left eye. Fundoscopy of both eyes revealed serous retinal detachment in the absence of background retinal changes. On urgent admission to the maternity assessment unit, blood pressure was 189/126 mmHg and urine dipstick revealed 4+ proteinuria. Due to recurrent poor foetal heart rate variability on cardiotocography monitoring, an emergency caesarean was conducted. Sixteen hours following delivery, visual symptoms had improved, and clinical examination revealed normal blood pressure. An optical coherence tomography scan performed three months later was dry bilaterally with minor retinal pigment epithelium clumping. Serous retinal detachment involves the separation of the neurosensory retinal layer from the underlying retinal pigment epithelium. It is rare in pre-eclampsia but can be seen in patients with severe disease. The presentation of serous retinal detachment includes acute visual loss, reduced visual acuity, floaters, and flashing lights appearing in the vision. Although alarming on initial presentation, resolution is commonly seen within a couple of days postpartum. The pathogenic mechanism for serous retinal detachment development is widely discussed and thought to include changes to the choroidal circulation. Overall, although often self-resolving, a move to thorough antenatal care and vigilant monitoring in pre-eclamptic women is vital to prevent complications like this from occurring.
摘要：
我们报告了一例31岁的gravida2para1女性，在妊娠29周时有两周的视力模糊和持续性头痛病史。呈现时的视敏度在右眼为6/100,在左眼为6/24。双眼眼底镜检查显示，在没有背景视网膜变化的情况下，浆液性视网膜脱离。在紧急进入产妇评估单位时，血压为189/126mmHg，尿液试纸显示4蛋白尿。由于心脏造影监测中反复出现的不良胎儿心率变异性，进行了紧急剖腹产。交货后16小时，视觉症状有所改善，临床检查显示血压正常。三个月后进行的光学相干断层扫描扫描双侧干燥，视网膜色素上皮少量结块。浆液性视网膜脱离涉及神经感觉视网膜层与下面的视网膜色素上皮的分离。它在先兆子痫中很少见，但在严重疾病的患者中可以看到。浆液性视网膜脱离的表现包括急性视力丧失，视力下降，漂浮物,和闪烁的灯光出现在视野中。尽管在最初的介绍中令人震惊，决议通常在产后几天内看到。浆液性视网膜脱离发展的致病机制已被广泛讨论，并认为包括脉络膜循环的变化。总的来说,虽然经常自我解决，对先兆子痫妇女进行彻底的产前护理和警惕监测对于防止此类并发症的发生至关重要。
