Purtscher-Like Retinopathy Associated with Synthetic Cannabinoid (Bonzai) Use

Abstract

Purtscher’s retinopathy is a microvascular occlusive disease initially described as retinal edema, cotton wool-like exudation, and hemorrhages occurring after severe head trauma. A similar clinical presentation called Purtscher-like retinopathy is associated with systemic diseases instead of trauma. In the present case, ophthalmic eksamination of a patient with complaints of blurred vision related to substance (Bonzai) use revealed bilateral cotton-wool spots. Purtscher-like retinopathy was diagnosed based on fluorescein angiography and optical coherence tomography findings. This is the first case of Purtscher-like retinopathy associated with Bonzai use described in the literature.

Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography

“…OCT mostly indicates retinal oedema at the macula. Recent studies have reported cystoid macular oedema or even subretinal fluid in patients with PUR [7]. PAMM lesions, a special OCT feature of PUR discovered in recent years, present as hyperreflective bands at the INL in OCT, indicating an ischaemic condition at the outer retinal capillary plexus [8].…”

Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography

“…OCT mostly indicates retinal oedema at the macula. Recent studies have reported cystoid macular oedema or even subretinal fluid in patients with PUR[7]. PAMM lesions, a special OCT feature of PUR discovered in recent years, present as hyperreflective bands at the INL in OCT, indicating an ischaemic condition at the outer retinal capillary plexus[8].This patient also presented low perfusion in the retina layer.…”