Bilateral retinal occlusion progressing to long-lasting blindness in severe preeclampsia.

BACKGROUND: Temporary blindness in pregnancy associated with preeclampsia has been reported. Most cases have been attributed to cortical cerebral edema with transient vision impairment. We present a patient with bilateral retinal arteriole occlusions causing permanent blindness. CASE: A teenage primigravida at term presented with uterine contractions and preeclampsia. Twenty-four hours after delivery she developed sudden visual loss that progressed to total bilateral blindness. Imaging studies ruled out cerebral edema and an ophthalmologic examination found retinal hemorrhages and infarcts consistent with bilateral central retinal arteriole occlusions. At 2- and 6-month follow-up there was marked persistent visual impairment.
CONCLUSION: The combination of blindness and preeclampsia is rare. Evaluation for ophthalmologic findings should be part of the initial patient assessment with preeclampsia.