Bilateral retinal detachment in association with preeclampsia

Abstract

Bilateral, serous, non-rhegmatogenous retinal detachment is a rare complication of preeclampsia. Duke-Elder and Dobree (1967) stated than Van Graefe reported the first case in 1855. Since then 24 further cases have been reported--Wagener (1933), Wahrsinger (1943), Singh (1953), Bosco (1961), Gitter (1968), Klein (1968), Kenny (1972), Mabie (1980) and Oliver (1980). The incidence over the past 40 years appears to be decreasing and probably reflects the lower incidence of severe preeclampsia as a result of better antenatal care. These detachments are bilateral, serous and non-rhegmatogenous i.e. atraumatic. They often only involve the posterior pole. Bosco (1961) arrived at an incidence of 1 in 18,524 pregnancies. Previous case reports have suggested a higher incidence in primigravidas and all previous cases have occurred antenatally. In all but 1 previous case (Mabie, 1980), the detachment occurred concomitantly with hypertensive retinopathy. We report a multigravida with preeclampsia who, in the absence of any hypertensive retinopathy, developed bilateral, bullous retinal detachments in the puerperium.