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Reversible cortical blindness in preeclampsia.

Diana V Do1, Vivian Rismondo, Quan Dong Nguyen

  • 1Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. dianavdo@yahoo.com

American Journal of Ophthalmology
|December 10, 2002
PubMed
Summary
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Preeclampsia can cause reversible cortical blindness, a rare complication. This case highlights the importance of recognizing and managing visual disturbances in pregnant patients.

Area of Science:

  • Neurology
  • Obstetrics
  • Radiology

Background:

  • Preeclampsia is a serious pregnancy complication characterized by hypertension and potential organ damage.
  • Visual disturbances, including cortical blindness, are rare but significant neurological manifestations of preeclampsia.

Observation:

  • A 28-year-old pregnant patient at 37 weeks presented with headache and hypertension, rapidly progressing to severe visual impairment (light perception).
  • Initial examination revealed reactive pupils and normal fundi, despite profound vision loss.

Findings:

  • Brain magnetic resonance imaging (MRI) demonstrated increased signal intensity in the occipital lobes, consistent with vasogenic edema.
  • Following an emergent cesarean section, the patient's visual acuity returned to normal (20/20) within one month.

Related Experiment Videos

  • Follow-up MRI confirmed complete resolution of the occipital lobe abnormalities, supporting the reversibility of the condition.

    • Implications:

    • Cortical blindness in preeclampsia is likely due to reversible vasogenic edema rather than irreversible vasospasm.
    • This case underscores the importance of prompt neuroimaging and multidisciplinary management for visual complications in preeclampsia.
    • Early recognition and intervention can lead to favorable visual recovery in patients with preeclampsia-associated cortical blindness.