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This abstract is assigned to session Poster session in O'Bistro

Title

Acute choroidal ischemia as a result of pre-eclampsia associated with PRES and HELLP syndromes: a clinical case.

Purpose	To describe the case of a patient who developed choroidal ischemia and retinal detachment as late manifestation of eclampsia associated in post-partum time with mild PRES (Posterior Reversible Encephalopathy Syndrome) and severe, prolonged HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low Platelets).
Methods	Review of a clinical case.
Results	After an early delivery at 35 weeks caused by pre-eclampsia, the patient developed a severe eclampsia associated with HELLP syndrome. Despite subjective bilateral decreased vision, the ophthalmological examination at the intensive care unit was unremarkable. The brain MRI showed left parietal PRE Syndrome. Six days later, bilateral macular oedema was confirmed by fundus examination. Parietal lesions improved on MR imaging but bilateral choroidal thickening appeared associated with visual acuity of 0.1 RE and 0.2 LE. Fluorescein angiography and OCT confirmed both choroidal ischemia and serous neuroretinal macular detachment. The patient was treated with 1g IV methylprednisolone, 30 mg nifedipine and 500 mg acetazolamide 3 times per day for eight days. Visual acuity progressively improved while the corticosteroids were tapered for four weeks. Six months later, ocular examination confirmed almost full functional recovery.
Conclusion	Visual loss due to choroidal ischemia might be a late complication of eclampsia and HELLP syndrome. Visual recovery is usually complete with a prompt management of the aetiology. As corticosteroids and acetazolamide have been recommended in the literature, our case showed an almost complete recovery of visual function.

Author 1

Last name	DELAHAUT
Initials	A
Department	Université Catholique de Louvain
City	Brussels

Author 2

Last name	VERTES
Initials	D
Department	Université Catholique de Louvain
City	Brussels

Author 3

Last name	BOSCHI
Initials	A
Department	Université Catholique de Louvain
City	Brussels