Bilateral Serous Retinal Detachment in Pregnancy

Abstract

Serous retinal detachment is a rare complication of pregnancy. A 30-year-old primigravida with preeclampsia presented with bilateral blurring of vision and metamorphopsia for a one-week duration. She was referred by the Obstetrics and Gynecology department for visual assessment. Her best corrected visual acuity was 6/7.5 in both eyes. Fundus examination revealed bilateral serous retinal detachment involving maculae. She was treated conservatively and her blood pressure normalized after delivery. There was a partial resolution of subretinal fluid one-month post-delivery and a complete resolution of subretinal fluid three months later. Her final best corrected visual acuity was 6/6 and N5 in both eyes. The management of serous retinal detachment is conservative with a good visual outcome.

A Case Report of Bilateral Exudative Retinal Detachment in Severe Pre-eclampsia

“…Choroidal changes include vascular narrowing, vasoconstriction, and extravasation of fluid into the extravascular spaces, and retinal changes include cotton wool spots, intraretinal haemorrhages, and decreased retinal arteriole-to-vein ratio on fundoscopy. The absence of these hypertensive retinopathy changes whilst acknowledging serous retinal detachment as a complication of hypertensive retinopathy and pre-eclampsia is also noted in several case reports [1,9,13]. A study performed by Reddy et al involving 78 patients with pregnancy-induced hypertension showed many of their patients had grade 1 or grade 2 retinal changes according to the Keith-Wagener hypertensive retinopathy classification system, and no patients had evidence of hard exudates, cotton wool spots, haemorrhages, and optic disc swelling.…”

“…The anatomical course and absent autoregulation of the choroidal circulation are noted by Jayaraj et al to result in the vulnerability of hypertensive-induced changes in the choroidal capillaries as opposed to the retinal vasculature [ 8 ]. Furthermore, fluorescein angiography studies performed by Komoto et al also support evidence of choroidal circulation involvement through patchy delay in choroidal perfusion within the early phase and fluorescein leakage in the same area in the late phase, with no abnormality seen in retinal perfusion [ 9 ]. However, limited studies involving fluorescein angiography in pregnancy are available due to the risks of teratogenicity.…”