Purtscher's retinopathy: a case report and review

Caplen, Stuart M.; Madreperla, Steven A.

doi:10.1016/j.ajem.2007.12.015

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…Purtscher's retinopathy is a rare condition that was first described in 1910 by Otmar Purtscher. Purtscher encountered a case of traumatic retinopathy secondary to head trauma which was associated with sudden blurring of vision [ 1 ]. Later a similar finding was noted in cases related to various types of trauma, including seatbelt and airbag pressure, malar bone fracture, crush injury, and chest trauma [ 1 - 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Purtscher encountered a case of traumatic retinopathy secondary to head trauma which was associated with sudden blurring of vision [ 1 ]. Later a similar finding was noted in cases related to various types of trauma, including seatbelt and airbag pressure, malar bone fracture, crush injury, and chest trauma [ 1 - 4 ]. Purtscher-like retinopathy is seen in patients with acute pancreatitis, systemic lupus erythematous, HELLP syndrome, and renal failure, as well as in patients with adenocarcinoma of the pancreas with no relation to trauma [ 5 - 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Purtscher's retinopathy is a rare condition and is noted in cases associated with various types of trauma, including head trauma, seatbelt and airbag pressure, malar bone fracture, crush injury, and chest trauma [ 1 - 4 ]. The fundus characteristics are Purtscher flecken, which are multiple cotton wool spots of varying sizes.…”

Section: Introductionmentioning

confidence: 99%

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Purtscher-like retinopathy following valsalva maneuver effect: case report

2011

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IntroductionPurtscher's retinopathy is a rare condition that is noted in cases related to various types of trauma. The characteristic finding in the fundus is the presence of multiple Purtscher flecken. Purtscher-like retinopathy has a similar presentation in the fundus, but without an association with trauma.Case presentationA 43-year old Malay man presented with a sudden onset of central foggy vision in the left eye after holding his breath for two minutes while catching a falling object. It was not associated with floaters, flashes of light, or head trauma. His vision in the right eye was 6/6, and in his left eye it was finger counting. He had bilateral temporal sub-conjunctival hemorrhages. An examination of his left fundus revealed multiple white cotton wool spots and dot-blot retinal hemorrhages with diffuse retinal edema at the posterior pole. His right fundus was noted to have only mild temporal peri-papillary edema associated with a few dot-blot hemorrhages. Fundus fluorescein angiography showed good arterial perfusion and no evidence of leaking or neo-vascularization. A diagnosis of Purtscher-like retinopathy was made, and the patient was treated with indomethacin tablets for six weeks. At his six-week follow-up examination, his left eye visual acuity had improved to 6/12. His bilateral sub-conjunctival hemorrhage had resolved. His left fundus showed residual multiple cotton wool spots and reduced retinal edema.ConclusionsTreatment with non-steroidal anti-inflammatory drugs seems to be effective in reducing edema in patients with Purtscher-like retinopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Purtscher-like retinopathy following valsalva maneuver effect: case report

2011

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“…On the other hand, Purtscher's flecken do not obscure the retinal vessels; they are polygonal plaque-like lesions and are the result of precapillary arteriole occlusions in the inner nuclear layer. 12,13 Additionally, the pathognomonic finding of Purtscher's flecken has a unique characteristic: a clear demarcation zone between the white lesion and the adjacent retinal vessel (Figure 4). This area of normal retina represents the perivascular capillary-free or avascularized zone, which extends about 50 µm on either side of a vessel.…”

Section: Signs and Symptomsmentioning

confidence: 99%

Purtscher’s-Like Retinopathy Following Acute Pancreatitis

Melkumyan

Yeh

Ferrucci

2020

CRO (Clinical &Amp; Refractive Optometry) Journal

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Background: Purtscher’s retinopathy is a rare condition that results from trauma to the head, neck or thorax. Purtscher’s-like retinopathy is similar in appearance to Purtscher’s retinopathy but occurs in association to various systemic conditions, including acute pancreatitis. Both are a result of occlusion of precapillary arterioles by small and intermediate sized emboli and present with retinal whitening and intraretinal hemorrhages throughout the posterior pole. Other findings may include optic nerve edema, macular edema, macular ischemia and serous macular detachment. Patients are often symptomatic for reduced vision and visual field loss. Case Report: A 23-year-old African American male presented with reduced vision in both eyes following hospitalization for the treatment of acute pancreatitis secondary to alcohol abuse. Fundus examination revealed extensive peripapillary retinal whitening in both eyes with a few intraretinal hemorrhages. Optical coherence tomography of the macula revealed a serous detachment in both eyes. Improvement in visual acuity and partial resolution of the macular subretinal fluid was observed upon follow up. Conclusion: Purtscher’s and Purtscher’s-like retinopathy are thought to be self-limiting conditions that resolve without ocular treatment. Following resolution of the acute retinal findings, patients can be left with visual acuity and/or visual field loss. While there is currently no accepted treatment for the retinopathy itself, it is important to treat the associated systemic condition. CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/purtschers-like-retinopathy-following-acute-pancreatitis) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.

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“…Purtscher's retinopathy (PR) was firstly defined by Otmar Purtscher in 1910 in a patient following head trauma. Fundus examination in both eyes displayed various sizes of cotton wool spots with intraretinal hemorrhages limited to posterior pole which were named Purtscher flecken [ 1 , 2 ]. Besides traumatic PR, this characteristic fundus view has been found in several disorders including acute pancreatitis, hemolysis, elevated liver enzyme levels and low platelet levels (HELLP) syndrome, hemolytic uremic syndrome, amniotic fluid embolism, thrombocytopenic purpura, and renal failure in which all were named Purtscher-like retinopathy [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Purtscher-Like Retinopathy Associated with Anorexia Nervosa

Karasu

Günay

Erdoğan

et al. 2016

Case Reports in Ophthalmological Medicine

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A 21-year-old girl presented with acute painless vision loss in her right eye. There was no remarkable ocular history and she had a history of anorexia nervosa. At presentation best-corrected visual acuities were counting fingers from 2 meters and 20/20, in the right and left eyes, respectively. Slit lamp examination result was normal. Fundus examination revealed multiple cotton wool spots and intraretinal hemorrhages surrounding the optic disc and macula in the right eye. Fluorescein angiography showed capillary filling defect and leakage from optic disc in the late phase of the angiogram. One week later best-corrected visual acuities remained the same in both eyes with similar fundus appearance. One month after initial presentation visual acuity was 20/20 in both eyes with no abnormality in fundus appearance.

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Purtscher's retinopathy: a case report and review

Cited by 7 publications

References 11 publications

Purtscher-like retinopathy following valsalva maneuver effect: case report

Purtscher-like retinopathy following valsalva maneuver effect: case report

Purtscher’s-Like Retinopathy Following Acute Pancreatitis

Purtscher-Like Retinopathy Associated with Anorexia Nervosa

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