RESUMO
Abstract Pre-eclampsia (PE) is an obstetric disease with a multifactorial cause that affects ∼ 5% of pregnant women. Vision can be affected with varying severity, and retinal detachment is a very rare complication. It tends to be bilateral, diagnosed postpartum, and more prevalent in women who are primiparous and/or undergo caesarean delivery. The condition typically resolves completely and rarely causes total visual loss in the affected women. Fluorescence angiographic findings support the hypothesis that retinal detachment in PE is secondary to choroidal ischemia from intense arteriolar vasospasm. The present article is related to a case of a 37-year-old pregnant woman who had PE associated with a progressive blurred vision, diagnosed by ophthalmology as serous macular detachment of the retina.
Resumo A pré-eclâmpsia (PE) é uma doença obstétrica com uma causa multifactorial que afeta ∼ 5% das grávidas. A visão pode ser afetada com uma gravidade variável, sendo o descolamento de retina uma complicação muito rara. Geralmente é bilateral e seroso, e a sua patogênese encontra-se relacionada com a isquemia coroidal, secundária a um intenso vaso espasmo arteriolar. A maioria dos doentes tem recuperação completa da visão com tratamento conservador. No presente artigo, é relatado um caso de uma grávida de 37 anos que desenvolveu PE com critérios de gravidade associada a um quadro de visão turva progressiva, diagnosticada pela oftalmologia como descolamento macular seroso da retina.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Pré-Eclâmpsia , Diagnóstico Pré-Natal , Descolamento Retiniano/diagnóstico , Terceiro Trimestre da Gravidez , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico por imagem , CesáreaRESUMO
PURPOSE: To report three various cases of retinal hemorrhages caused by Plasmodium vivax malaria. CASE SUMMARY: Two 55-year-old male patients and a 52-year-old male patient with cyclic high fever were admitted to the department of internal medicine. Three of the patients were diagnosed with malaria caused by P. vivax based on a peripheral blood smear. The patients were treated with hydroxychloroquine and premaquine but complained of decreased visual acuity. The patients were examined with funduscopy, fluorescein angiography, and optical coherence tomography. The first case showed 2 areas of retinal hemorrhages on the macular in the right eye and 1 area of retinal hemorrhage in the left eye. The second case showed many cotton-wool spots along with a number of small retinal hemorrhages and tortuous blood vessels in both eyes. The third case showed 1 area of retinal hemorrhage in the right eye and many cotton-wool spots in both eyes. CONCLUSIONS: P. vivax malaria rarely causes retinal hemorrhage. Manifestations of retinal hemorrhage and degree of visual acuity loss may vary among patients. P. vivax malaria should be considered when patients with unexplained high fever present with retinal hemorrhage, even without a history of overseas travel.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Vasos Sanguíneos , Olho , Febre , Angiofluoresceinografia , Hidroxicloroquina , Medicina Interna , Malária , Malária Vivax , Plasmodium , Plasmodium vivax , Hemorragia Retiniana , Retinaldeído , Tomografia de Coerência Óptica , Acuidade VisualRESUMO