Our patient was referred for asymptomatic macular pigmentary changes. Vision was 20/20 OD and 20/25 OS. On further questioning, she reported severe vision loss with toxemia just before her now 16 YO daughter was born.
Learning Points:
Preeclampsia (toxemia of pregnancy), which usually develops in the third trimester, manifests as severe hypertension, swelling of the legs, feet, and hands, and proteinuria. When seizures develop, the condition is called eclampsia. This may lead to serious and possibly fatal effects for both the mother and child.
Patients may develop hypertensive retinopathy. Choroidal ischemia can cause infarction of the RPE with exudative and hemorrhagic retinal detachment.
These changes usually resolve rapidly with delivery, although they can cause chorioretinal changes that mimic numerous entities, including central serous retinopathy and macular/retinal dystrophies.
