Central retinal vein occlusion and HELLP syndrome

PURPOSE

To present a rare case of central retinal vein occlusion in conjunction with the HELLP syndrome.

METHODS

A 30-year-old woman presented in the 28th week of her second pregnancy with severe pre-eclampsia with HELLP syndrome; delivery by caesarean section was recommended. Ten days later, the patient complained of severely decreased visual acuity in her right eye.

RESULTS

Ophthalmoscopy revealed a central retinal vein occlusion with venous engorgement and tortuosity, multiple flame hemorrhages, and disc and macular edema. Electroretinography revealed a reduction of b-wave/a-wave ratio. Fluorescein-angiography showed a blockage due to extensive retinal hemorrhages with late mild staining of the walls of veins. The patient presented a spontaneous improvement in visual acuity (0.8 two months after) and a complete resolution of ophthalmoscopic findings.

CONCLUSION

Ophthalmic complications are possible during and soon after this syndrome. This is the first description of a patient suffering a central retinal vein occlusion during puerperium after the HELLP syndrome.

[Inhibitory effect of nicardipine on fibroblast proliferation mechanisms]

PURPOSE

To assess the effect of nicardipine (NCP) on fibroblast migration and proliferation, and its cellular toxicity.

METHODS

In vitro wound repair was assessed in confluent fibroblast monolayer. Mechanical round wounds were performed in the monolayers and the cultures were incubated in fresh media plus NCP. The cell-free area was monitored after 0, 18, 24 and 48 hours. Groups of treatment: Group 1, Sham. Group 2, NCP 10(-4)M in the media. Group 3, NCP 7.5x10(-5)M. Group 4, NCP 5x10(-5)M. Group 5, NCP 2.5x10(-5)M. Group 6, NCP 10(-5)M. Group 7, NCP 10(-6)M. Group 8, NCP 10(-7)M. Group 9, NCP 10(-3)M. Each experiment consisted of three tests that were repeated four times.

RESULTS

The fibroblast migration and proliferation was inhibited at 5x10(-5)M or higher doses. The proliferation after 48 hours with NCP 2.5x10(-5)M was statistically inferior to the control group and groups 7, 8, and 9. NCP 5x10(-5)M or higher doses showed cellular atypia and cell death.

CONCLUSIONS

NCP effectively inhibits fibroblastic wound repair process at doses 2.5x10(-5)M and shows toxicity at doses over 5x10(-5)M.