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JAMA Ophthalmology Clinical Challenge
August 2018

Subacute Vision Loss in a Young Pregnant Patient With Proliferative Diabetic Retinopathy

Author Affiliations
  • 1Department of Ophthalmology, University of California, San Francisco, San Francisco
  • 2Department of Ophthalmology, Permanente Medical Group, San Francisco, California
JAMA Ophthalmol. 2018;136(8):948-949. doi:10.1001/jamaophthalmol.2017.6760

A woman in her mid-20s presented with subacute bilateral vision loss that was worse in the left eye. Her medical history was remarkable for type 1 diabetes diagnosed at 16 years of age and proliferative diabetic retinopathy in both eyes that had been treated with panretinal photocoagulation 7 years earlier. She had undergone pars plana vitrectomy with endolaser to treat a tractional retinal detachment in her right eye 2 years before this presentation. She also had a history of hypertension and chronic kidney disease, and she was 15 weeks into pregnancy. Visual acuity was 20/50 OD and 20/100 OS. Intraocular pressure was normal bilaterally, and no relative afferent pupillary defect was detected. Findings of an anterior segment examination were normal. The patient was in no apparent distress and denied any headache, chest pain, or focal weakness.

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