Purtscher’s-like retinopathy as a rare complication 
of acute alcoholic pancreatitis

Wieczorek, Michalina M; Caban, M; Fabisiak, Adam; Małecka‐Panas, Ewa

doi:10.5114/pg.2021.106669

Cited by 4 publications

(4 citation statements)

References 21 publications

(38 reference statements)

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“…The definite treatment protocol for Purtscher retinopathy has not been established so far, and several studies on corticosteroid treatment did not demonstrate statistically significant improvements [3,5]. However, a high-dose steroid or prednisolone 1.5mg/kg/day dose improved symptoms [7,8], and in our case as well, she had significant improvement in symptoms with 1mg/kg/day dose. In contrast, a case is reported in the literature, where optic neuropathy treated with a high dose of steroid (methylprednisolone) caused drug-induced acute pancreatitis [4,9].…”

Section: Discussionsupporting

confidence: 44%

Optic Neuropathy as a Rare Ocular Complication of Acute Pancreatitis: A Case Report

Rana,

Thakali,

Shrestha

et al. 2024

Cureus

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Acute pancreatitis is a pancreatic inflammatory disorder that often leads to multi-organ dysfunction associated with systemic inflammatory response. Optic neuropathy is an extremely rare ocular manifestation that can occur especially in alcoholic pancreatitis most likely due to ischemic complications and is a vision-threatening condition that has to be recognized early as it can cause permanent vision loss. In this case report, a 51-year-old lady, an occasional consumer of alcohol, post-cholecystectomy status, presented with severe abdominal pain of four days' duration associated with multiple episodes of vomiting. She was diagnosed with moderate to severe acute pancreatitis and needed ionotropic support initially. She had improvement in gastrointestinal symptoms. However, she had left peri-orbital pain and lacrimation with blurring of vision on Day 11 of illness. Subsequently, an ophthalmic evaluation revealed optic disc oedema and a mild decrease in visual acuity but normal visual field and colour vision. Therefore, left optic neuropathy was diagnosed and a high-dose oral steroid was started on a tapering dose. Follow-ups after four and 12 weeks showed significant improvement in optic disc oedema and other symptoms. Therefore, though optic neuropathy is rarely reported in acute pancreatitis, it has to be considered in clinical practice along with Purtscher-like retinopathy, which presents with ocular symptoms in acute pancreatitis.

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Section: Discussionsupporting

confidence: 44%

Optic Neuropathy as a Rare Ocular Complication of Acute Pancreatitis: A Case Report

Rana,

Thakali,

Shrestha

et al. 2024

Cureus

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“…[ 1 ] Topical nepafenac eye drops were prescribed thrice daily in both eyes. [ 2 ] Post dialysis, there was a gradual improvement in the visual acuity (OD 6/9, N6; OS 6/6, N6) and resolution of Purtscher-flecken after a month [ Fig. 1d ].…”

Section: Resultsmentioning

confidence: 99%

Bilateral whitish lesions in the fundus of a young male

Vukkadala

Taureen²

2022

Indian Journal of Ophthalmology

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“…In three cases the patients were treated with corticosteroids (1 with intravitreal injections and 2 with systemic administration). 27,29,31 Most patients reported improved vision within 2-3 months, while in one of the cases the visual defects were permanent, and two of the patients died soon afterwards, hence there was no ophthalmology follow up (Table 1). 16,26,38 The low reporting rate of pancreatitis-induced Purtscher-like retinopathy could be due to low incidence of this pathology in the setting of acute pancreatitis or due to the low recognition rates of the association between visual pathology and acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Purtscher-like Retinopathy in a Patient with Acute Pancreatitis: A Case Report and Literature Review

Almpani

Ghannam

Roldán

et al. 2023

Journal of Brown Hospital Medicine

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Purtscher-like retinopathy is a rare chorioretinopathy associated with a non-traumatic inciting event including acute pancreatitis, renal failure, long-bone injury, chest compression, connective tissue diseases and hematologic disorders. We present the case of a 33-year-old woman with abdominal pain and visual changes that was diagnosed with acute pancreatitis. Fundoscopic examination revealed bilateral diffuse flame hemorrhages and retinal whitening (Purtscher flecken), which were diagnostic of Purtscher-like retinopathy secondary to acute pancreatitis. The patient improved without intravenous or intravitreal corticosteroid administration. Follow up at 5 and 8 months revealed improved vision, complete resolution of the retinal pathology with residual inner retinal thickening on ocular coherence tomography (OCT), consistent with sustained retinal damage. Given that Purtscher-like retinopathy is associated with higher morbidity and mortality rates in patients with acute pancreatitis, high suspicion of this pathology and a thorough clinical assessment are imperative. Since half of the patients suffer life-long visual changes, further research is required for the development of efficacious treatment options.

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Purtscher’s-like retinopathy as a rare complication of acute alcoholic pancreatitis

Cited by 4 publications

References 21 publications

Optic Neuropathy as a Rare Ocular Complication of Acute Pancreatitis: A Case Report

Optic Neuropathy as a Rare Ocular Complication of Acute Pancreatitis: A Case Report

Bilateral whitish lesions in the fundus of a young male

Purtscher-like Retinopathy in a Patient with Acute Pancreatitis: A Case Report and Literature Review

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