Efficacy of Purtscher’s Retinopathy Treatments: A Systematic Review

Xia, Duosheng; Chen, Xiaomei; Zhou, Qi; Xiao, Shujun; Yu, Yang; Wang, Yadong; Du, Gang; Huang, Haixiang; Zhang, Wenfang; Chen, Yaolong

doi:10.1080/02713683.2016.1255335

Cited by 23 publications

(17 citation statements)

References 42 publications

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“…Current treatments include glucocorticoid therapy, traditional Chinese medicine, and glucocorticoid integrative medicine therapy. A systematic review found that the difference between no treatment and glucocorticoid therapy showed no statistical significance [9]. In the present case, Purtscher's or Purtscher's-like retinopathy did not involve the macula of both eyes.…”

Section: Discussioncontrasting

confidence: 65%

A case of bilateral endogenous endophthalmitis misdiagnosed as Purtscher’s retinopathy

Huang

Yuan

2020

BMC Ophthalmol

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Background: Purtscher's retinopathy characterized by the appearance of cotton-wool spots and intraretinal hemorrhage at the posterior pole that commonly occurs after severe head and chest trauma. We report a patient who presented with multiple white retinal patches and retinal hemorrhage forty-two days after a severe thoracoabdominal trauma, which was misdiagnosed as Purtscher's retinopathy. Case presentation: A middle-aged woman presented to the eye clinic complaining of decreased vision and distortion in the right eye forty-two days after thoracoabdominal trauma. Upon first glance at her fundal appearances with multiple white retinal patches and retinal hemorrhage, we considered it to be bilateral Purtscher's retinopathy. No specific treatment was given to her. Ten days later, the four white retinal patches in the right eye joined together with star-shaped hard exudates and radial folds in the macula. This was not consistent with the characteristics of Purtscher's retinopathy. In retrospect, we found that the onset time, shape, and location of the white retinal patches were not cotton-wool spots. A detailed history revealed that she had Staphylococcus aureus septicaemia due to abdominal incision infection, and she underwent intravenous antibiotic therapy. Fundus fluorescein angiography (FFA) revealed hyperpermeable vasculature and extensive fluorescence leakage in the middle and late stages. Optical coherence tomography (OCT) revealed highly reflective exudates in the neuroepithelium and macular edema in the right eye. Taking her history and the FFA and OCT results into consideration, she was diagnosed with bilateral endogenous endophthalmitis. Conclusion: In the present case, multiple white patches and intraretinal hemorrhage at the posterior pole forty-two days after the trauma were not Purtscher's retinopathy. It was bilateral endogenous endophthalmitis. The subretinal abcesses that developed secondary to Staphylococcus aureus infection involved the macula causing decreased vision and distortion in the right eye. We concluded that in the case of multiple white retinal patches at the posterior pole in patients after trauma, especially in patients with infectious disease, Purtscher's retinopathy is not the only possible diagnosis. Correct diagnosis depends on reevaluation of the lesions by FFA and OCT, laboratory investigation and detailed history.

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Section: Discussioncontrasting

confidence: 65%

A case of bilateral endogenous endophthalmitis misdiagnosed as Purtscher’s retinopathy

Huang

Yuan

2020

BMC Ophthalmol

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“…Although it was reported that the difference between no treatment and glucocorticoid therapy had no statistical signi cance, the evidence quality for this conclusion was "very low" and had large bias [4] . Therefore, if possible, a further large-scale prospective study on these cases is necessary.…”

Section: Discussionmentioning

confidence: 93%

A Case of Onset and Treatment on Purtscher’s Retinopathy in a Single Eye

Yuan

Lian

Gao

2021

Preprint

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Background:Purtscher’s retinopathy is an occlusive microvasculopathy caused by traumatic injuries, especially like head and chest injuries. The exact mechanism of injury remains unclear, and Most case reports about Purtscher’s retinopathy focused on the symptoms of fundus, and did not provide detailed medical treatments. Case presentation: In this case, the patient suffered suddenly vision loss in the right eye one day after a traffic accident with moderate head and chest injuries. Ocular examinations revealed typical characteristics of cotton wool spots, and minimal intraretinal hemorrhages around the optic disc. 5 different drugs were used in this patient. 15 days after the treatment (corticosteroids and traditional Chinese medicine), the vision of the patient was improved and the symptoms (cotton wool spots, hemorrhages, retinal edema and visual field) were alleviated obviously. Conclusions: Corticosteroids and traditional Chinese medicines used in our case did improve the vision of the patient, and alleviated the symptoms of fundus.

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“…In literature, there have been case reports regarding the use of corticosteroid. There is no definitive guideline for the treatment of these cases [ 4 ].…”

Section: Discussionmentioning

confidence: 99%