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Case Reports
. 2016 Sep;20(9):545-7.
doi: 10.4103/0972-5229.190364.

Point-of-care ultrasonography of the orbit for detection of retinal detachment in a patient with hemolysis, elevated liver enzymes, and low platelet count syndrome

Gentle Sunder Shrestha  1 , Shayuja Rajbhandari  2 , Shashwat Dhungel  3 , Nutan Sharma  4 , Nimesh Poudel  4 , Dhiraj N Manandhar  5
Affiliations
Case Reports

Point-of-care ultrasonography of the orbit for detection of retinal detachment in a patient with hemolysis, elevated liver enzymes, and low platelet count syndrome

Gentle Sunder Shrestha et al. Indian J Crit Care Med. 2016 Sep.

Abstract

Retinal detachment is a rare, but well-known cause of visual impairment in patients with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. With supportive care, patients usually improve, with complete recovery of vision. Bedside ultrasonography of the orbit can be helpful for early detection of retinal detachment in these patients. Here, we present a case of HELLP syndrome presenting with severe visual symptoms. Retinal detachment was detected with point-of-care ocular sonography, which was confirmed with ophthalmoscopic examination. The patient was reassured of the favorable prognosis. Early initiation of aggressive supportive care was followed by progressive improvement of vision, which correlated with sonographic evidence of resolution of detachment. Her vision recovered completely in 2 weeks.

Keywords: Hemolysis; and low platelet count syndrome; elevated liver enzymes; point-of-care ultrasonography; retinal detachment.

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Figures

Figure 1
Figure 1
A linear hyperechoic membrane floating off the posterior globe (marked by white arrow), with the medial end attached to the margin of optic nerve head, suggestive of retinal detachment
Figure 2
Figure 2
Resolving retinal detachment (marked by white arrow)
See this image and copyright information in PMC

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