Skip to main content

  • Features of Serous Retinal Detachment in Preeclampsia and Malignant Hypertension

    By Lynda Seminara
    Selected By: Deepak P. Edward, MD
    Add to My Bookmarks

    Journal Highlights

    Eye (London)
    Published online May 14, 2019

    Download PDF

    Lee et al. looked at the characteristics of hypertensive choroidopathy with se­rous retinal detachment (SRD) in pre­eclampsia and malignant hypertension. They also explored the possibility of choroidal ischemia contributing to the pathogenesis of preeclampsia. Findings of their research suggest that elevated blood pressure affects the choroid ear­lier than the retina and that choroidal thickness declines after resolution of choroidopathy. Visual prognosis was better for patients with preeclamp­sia than for those with hypertension. The residual flow defects found in the choriocapillaris confirmed the long-hy­pothesized notion that ischemia is an underlying mechanism of hypertensive choroidopathy.

    For this retrospective case series, the researchers reviewed medical charts for 29 patients with preeclampsia (53 eyes) and 24 patients with hypertension (45 eyes). Clinical characteristics were documented, and multimodal imaging results were evaluated. The two cohorts were comparable in age, follow-up duration, baseline visual acuity, central macular thickness (CMT), and subfo­veal choroidal thickness. Blood pressure parameters (including pulse rate and systolic and diastolic blood pressure) were significantly higher in the hyper­tension group.

    After resolution of the SRD, reduc­tions in CMT (p < .001) and choroidal thickness (p = .003) were found to be greater in patients with preeclampsia (p < .001 and p = .003, respectively, vs. the hypertension group). Features of hypertensive retinopathy, including hemorrhage, exudates, cotton-wool spots, and optic disc edema, were more common in patients with hyperten­sion (p = .001). Final visual acuity was better in those with preeclampsia (p = .048). Factors linked to poor vision were the presence of retinopathy fea­tures (p = .005) and retinal detachment in the macula (p = .017).

    Although SRD hypertensive cho­roidopathy presented with choroidal thickening that decreased after resolu­tion, the residual flow defects observed in the choriocapillaris confirmed the long-hypothesized notion that ischemia is a mechanism behind hypertensive choroidopathy. To the authors’ knowl­edge, this study represents the first ap­plication of multimodal retinal imaging in the evaluation and comparison of clinical manifestations of SRD in pre­eclampsia and malignant hypertension.

    The original article can be found here.