Development of Purtscher-like retinopathy after pre-eclampsia combined with acute pancreatitis

Abstract

Visual disturbances are common among women with pre-eclampsia. The obstetricians should have an understanding of the various conditions associated with visual impairments. We report a case of Purtscher-like retinopathy developed after pre-eclampsia combined with acute pancreatitis. A 33-year-old primigravida with twin pregnancy was admitted to the department of obstetrics and gynecology for preterm labor and pre-eclampsia at 36+4 weeks gestation. After a cesarean section, she complained of abdominal pain and visual acuity loss. She was diagnosed with Purtscher-like retinopathy combined with acute pancreatitis after ophthalmologic examination and an abdominal computed tomography scan. Purtscher-like retinopathy, most often observed after trauma, is very rare in pre-eclampsia. In addition, while visual disturbances from other conditions are transient, it can result in persistent visual impairments. Thus, when a patient with pre-eclampsia complains of visual problems for a long period of time, obstetricians should consider an ophthalmologic evaluation and treatments during the earliest stage of the disease.

Purtscher’s retinopathy and renal cortical necrosis: two rare vaso-occlusive complications in a patient with acute pancreatitis: a case report

“…However, in about 20 % of cases, it can present in severe form with local and systemic complications. Acute pancreatitis rarely leads to Purtscher’s retinopathy and renal cortical necrosis [4, 17–23]. Though several mechanisms are described, both can be caused by a common phenomenon, which might have occurred in our patient.…”

“…In most of the cases, it is due to obstetric complications [13–16]. There are some isolated case reports of acute pancreatitis with Purtscher’s retinopathy [4, 17–23] and acute pancreatitis with renal cortical necrosis [10, 11, 24–29]. To our knowledge, the simultaneous presence of these two conditions is extremely rare; to date, only one case has been reported [25].…”

Bilateral Purtscher-Like Retinopathy With Profound Macular Ischemia and Vision Loss in Severe Pre-Eclampsia

“…Some form of hypertension complicates 5-7% of all pregnancies [8]. Pre-eclampsia is characterized by hypertension and proteinuria.…”

“…Pre-eclampsia is characterized by hypertension and proteinuria. Eclampsia occurs in approximately 0.5% of women with mild preeclampsia and in approximately 2-3% of those with severe preeclampsia [8]. Visual symptoms have been described to occur in approximately 25% of pre-eclamptic and 19-45% of eclamptic women.…”

“…It can occur in otherwise uncomplicated pregnancies barring pre-eclampsia and patients with severe eclampsia and seizures. Patients with HELLP syndrome and pancreatitis have been reported to develop Purtscher-like retinopathy [8]. It can also be associated with findings on neuroimaging consistent with brain infarcts [2][3][4][5][6][7].…”