Proportion and risk factors of retinal changes in pregnant women with HELLP syndrome

To report the proportion and risk factors associated with retinal changes in Chinese pregnant women diagnosed with HELLP syndrome.

A retrospective review of medical records was conducted for all pregnant women with HELLP syndrome delivered at the Second Affiliated Hospital of Wenzhou Medical University between September 2010 and August 2023. Retinal changes were identified and were categorized into retinal vascular changes and serous retinal detachment based on the ophthalmology consultation records. The proportion of retinal changes was calculated, and associated risk factors were analyzed.

A total of 70 cases with HELLP syndrome were included, with a mean age of 30.1 ± 5.2 years. Forty-nine cases received ophthalmology consultation, presenting a consultation rate of 70.0%. The proportion of retinal changes was 55.1% (27/49) in cases with HELLP syndrome. The proportion of retinal vascular changes and serous retinal detachment were 30.6% (15/49) and 24.5% (12/49), respectively. Patients with retinal vascular change (120.7 ± 8.0 mmHg) and those with serous retinal detachment (116.7 ± 14.5 mmHg) demonstrate significantly elevated diastolic blood pressure at the time of HELLP syndrome diagnosis compared to case without retinal changes (110.1 ± 12.4 mmHg, P = 0.032). HELLP syndrome cases treated with corticosteroids were more likely to develop serous retinal detachment compared to those not receiving corticosteroids (40.0% vs. 13.8%, P = 0.040).

The proportion of retinal changes was 55.1% among Chinese pregnant women with HELLP syndrome. Elevated diastolic blood pressure was identified as associated risk factor for developing retinal changes. The use of corticosteroids may have more risk of developing serous retinal detachment.