Purtscher-like retinopathy in a patient with HELLP syndrome.

Stewart, Michael W; Brazis, Paul W; Guier, Christian P; Thota, Sindhu H; Wilson, Shirley D · Am J Ophthalmol · 2007

case_report · Level V

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Abstract

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. Interventional case report. 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. 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. Purtscher-like retinopathy with permanent visual loss can occur antepartum in patients with HELLP syndrome.

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