Ocular Manifestations of Wernicke's Encephalopathy in a Patient with Hyperemesis Gravidarum Complicating Pregnancy.

Abstract

Wernicke's encephalopathy (WE) is a condition resulting from thiamine deficiency and has been linked to conditions such as hyperemesis gravidarum, anorexia nervosa, hemodialysis, and chronic alcoholism. The aim of the report is to outline the ocular manifestations of WE. We present the case of a 33-year-old woman, who presented in her second trimester of pregnancy with persistent vomiting, nystagmus, ataxia, global confusion as well as hypotonia, and tremors. She was subsequently diagnosed with WE complicating pregnancy. Ophthalmoscopy showed asymmetric superficial retinal hemorrhages at the peripapillary area in both eyes with associated retinal exudates. On treatment with thiamine supplementation, her systemic condition as well as ocular symptoms resolved. This is a rare case outlining the ocular manifestations of WE. This condition may cause serious, lasting neurologic impairments or death if not properly treated. Only 50% of these pregnancies end in the delivery of healthy offspring. Early diagnosis and treatment of these cases can prevent avertable consequences.