White-centered retinal hemorrhages as an early sign of preeclampsia

We examined a pregnant patient who had symptomatic white-centered retinal hemorrhages. Severe preeclampsia rapidly developed despite the patient not having hypertension, proteinuria, or edema at initial examination.

Retinal hemorrhages gradually resolved without treatment and visual acuity returned to 20/20 six months after emergency delivery of a healthy infant. Retinal or choroidal vascular abnormalities in pregnant patients may be caused by early preeclampsia and immediate obstetric referral is indicated.