Transient Bilateral Amaurosis as the Initial Manifestation of Posterior Reversible Encephalopathy Syndrome (PRES) in a Patient with Preeclampsia with Severe Features

A Case Report

Abstract

Introduction: Preeclampsia with severe features may be associated with serious neurological complications, including posterior reversible encephalopathy syndrome (PRES), an uncommon entity that may present with acute visual disturbances such as transient bilateral amaurosis. Objective: To describe the clinical presentation, diagnostic approach, management, and outcome of a patient with bilateral amaurosis secondary to PRES in the setting of a hypertensive disorder of pregnancy. Methods: A case is presented of a 42-year-old woman at 28 weeks of gestation who was hospitalized with severe hypertension and sudden bilateral vision loss. A multidisciplinary clinical evaluation was performed, including laboratory testing for hypertensive disorders of pregnancy and a cranial computed tomography (CT) scan as part of the diagnostic workup. The patient's clinical course was documented throughout hospitalization and the immediate postpartum period. Results: A diagnosis of preeclampsia with severe features complicated by PRES was established. Due to persistent neurological manifestations despite initial antihypertensive and neuroprotective management, immediate pregnancy termination was decided. During the postpartum period, the patient developed difficult-to-control hypertension, followed by progressive visual recovery and favorable neurological evolution without permanent sequelae. Conclusion: Early recognition of PRES in patients with hypertensive disorders of pregnancy and acute visual symptoms allows timely multidisciplinary management, with pregnancy termination being a key intervention to improve maternal prognosis.

Recibido: 14/04/2026

Aprobado: 19/08/2026