Bos A M, van Loon A J, Ameln J G
Afd. Gynaecologie en Obstetrie, Martini Ziekenhuis, Groningen.
Ned Tijdschr Geneeskd. 1999 Nov 27;143(48):2430-2.
A 31-year-old woman with severe pre-eclampsia developed bilateral serous retinal detachment on the second day post partum. After a few days there was spontaneous resorption of the subretinal fluid and the visual acuity improved. Ophthalmic examination showed no signs of hypertensive retinopathy. Some changes of the retinal pigment epithelium thought to represent healed infarcts of the choriocapillaris remained. Spontaneous retinal detachment is an uncommon complication of (pre)eclampsia, occurring both ante partum and post partum. Retinal and choroidal vascular damage have been implicated in the pathogenesis. Fluorescein angiographic observations lend support to the hypothesis that retinal detachment is secondary to choroidal vascular damage. The management of retinal detachment as a complication in obstetrics is conservative and the prognosis is good. Retinal detachment in (pre)eclampsia may be an indication for termination of pregnancy.
一名31岁患有重度子痫前期的女性在产后第二天出现双侧浆液性视网膜脱离。几天后,视网膜下液自发吸收,视力改善。眼科检查未发现高血压性视网膜病变的迹象。视网膜色素上皮的一些变化被认为代表脉络膜毛细血管愈合的梗死灶。自发性视网膜脱离是子痫前期少见的并发症,可发生于产前和产后。视网膜和脉络膜血管损伤与发病机制有关。荧光素血管造影观察结果支持视网膜脱离继发于脉络膜血管损伤这一假说。产科并发症视网膜脱离的治疗是保守的,预后良好。子痫前期的视网膜脱离可能是终止妊娠的指征。