Given these findings, the diagnosis of retinal ischemia due to suspected purtscherlike retinopathy was made. We report a case of purtscherlike retinopathy in the context of acute pancreatitis secondary to. It is due to the activation of complement and agglutination of red blood cells within retinal vessels. Otmar purtscher as a syndrome of sudden blindness associated with a distinctive fundoscopic picture characterized by multiple patches of superficial retinal whitening and intraretinal hemorrhages surrounding the optic disc in patients who have sustained head trauma. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. A sudden loss of vision attributable to purtscherlike retinopathy occurred in a 4yearold boy with focal segmental glomerulosclerosis and nephrotic syndrome as well as mild chronic renal failure. Purtschers retinopathy traumatic retinal angiopathy. Rest of anterior segment was unremarkable in both eyes. Purtschers retinopathy, due to microembolizations in the choroidal and retinal arterioles. However, the exact cause of the disease is not well understood. Brice critser, cra and susan wright, cra posted march 8, 2018. Purtscher like retinopathy as an initial presentation of thrombotic thrombocytopenic purpura. The short duration and rapid progression of symptoms along with the lack of family history of night blindness prompted a diagnosis of autoimmune retinopathy air. The main symptom reported by patients is sudden, painless deterioration of vision, which can affect one or both eyes.
The pathogenesis underlying purtscher retinopathy is not clear, but might be related to the embolic occlusion of. This article is from journal of medical case reports, volume 5. Purtschers retinopathy is a visionthreatening state that most frequently occurs in young or middleaged males after head or chest injury. Patient fell asleep while driving his truck and had no recollection of. This 21 year old male noted a significant unilateral decrease in vision two days after an allterrain vehicle atv rollover accident in which he suffered head trauma and a fractured rib. Purtschers retinopathy conditionkeywords purtschers retinopathy photographer jason s. Purtschers retinopathy conditionkeywords purtschers retin opathy photographer jason s.
Purtscher disease definition of purtscher disease by. Purtscher retinopathy and necrotizing vasculitis with. There are no consensual guidelines of the therapeutic approach of this 5 apr 2018 the most important clinical symptom of purtscher retinopathy is a diminished. Purtscher retinopathy transient traumatic retinal angiopathy due to a sudden rise in venous pressure, as in compression of the body from seat belt injury. Purtschers retinopathy is a rare condition that is noted in cases related. Fundoscopy of patients right eye showing cottonwool spots. Purtscher retinopathy purtscher retinopathy is a form of retinopathy. Ophthalmic examination revealed violaceous eruption on eyelids with swelling. Purtscher retinopathy is a haemorrhagic and vasoocclusive vasculopathy and was first described as a syndrome of sudden blindness associated with severe head trauma.
The ophthalmological picture is one of ischaemia at the posterior pole with white patches of oedema and haemorrhages concentrated around the. Jeffrey maassen, md, thomas oetting, md may 18, 2005. Purtschers retinopathy is a disease where part of the eye is damaged. Purtschers retinopathy is a microvasculopathy that has been well documented but poorly understood. Purtscher s retinopathy presents to the clinician as loss of vision in a patient with a history of a possible precipitating event such as recent major trauma, pancreatitis, childbirth or renal failure. Purtschers retin opathy is characterized by sudden visual loss in severely traumatized patients and is associated with multiple areas of superficial retinal whitening. Purtscherlike retinopathy following valsalva maneuver. Purtscher like retinopathy associated with acute pancreatitis was first described in 1975 by inkeles and walsh. The patient returned to korea 5 days later and was lost to followup. Purtschers retinopathy presents to the clinician as loss of vision in a patient with a history of a possible precipitating event such as recent major trauma, pancreatitis, childbirth or renal failure. Calhoun, department of ophthalmology, mayo clinic jacksonville, florida imaging device fundus camera description 19yearold female who just recently gave birth to a baby had sudden loss of vision in both eyes. Purtscherlike retinopathy is a rare and severe angiopathy that begins within some hours to some days after the onset of the systemic disease and is characterized by confluent cottonwool spots in the posterior pole, few intraretinal hemorrhages, and purtscher flecken in the acute phase.
An 18yearold woman with lower extremity muscle weakness was admitted due to decreased vision of both eyes for two weeks. Purtscherlike retinopathy should not be neglected in complex clinical contexts. Pdf purtscherlike retinopathy is associated with retinal hemorrhages and ischaemia probably due to the. Purtschers retinopathy is traumainduced embolization of retinal vasculature likely leukocyte, platelet, fibrin, or fat emboli, with infarction of the nerve fiber layer. We present a case of a 53yearold man who presented with a purtscherlike retinopathy associated with the development of acute pancreatitis in the context of a. Purtscherlike retinopathy presented a honeycomblike pattern in. Purtschers retinopathy is a disease where part of the eye retina is damaged.
The trip database provides clinical publications about. It provides information about diabetic retinopathy and answers questions about the cause and symptoms of this progressive eye disease. A 43year old malay man presented with a sudden onset of central foggy vision in the left eye. To report a rare case of bilateral purtscherlike retinopathy in a chinese female patient with dermatomyositis. It can threaten vision, leading to temporary or permanent blindness. Purtscherlike retinopathy associated with high altitude travel.
Ocular fundus examination revealed multiple cotton wool spots and purtscher. There are no consensual guidelines of the therapeutic approach of this condition. Purtschers retinopathy after intramedullary nailing of a femoral shaft. Since this first report, similar retinal appearance has been. Purtschers retinopathy is a rare condition that is noted in cases related to various types of trauma. Diabetes mellitus is extremely common, so it is not surprising. Purtscherlike retinopathy has a similar presentation in the fundus, but without an association with trauma. It is the number one cause of blindness in people between the ages of 2064 in the united states. What you should know this booklet is for people with diabetic retinopathy and their families and friends. A diagnosis of purtscherlike retinopathy was made, and observation was recommended. Purtscher like retinopathy is a rare and severe angiopathy that begins within some hours to some days after the onset of the. The diseases leads to the formation of cotton wool spots in the retina, a finding observed in several other diseases, and atrophy of the optic nerve. It is a rare and severe angiopathy found in conditions such as acute pancreatitis.
A wellillustrated and comprehensive analysis of the treatment of diabetic retinopathy, this book covers. Purtschers retinopathy purtschers retinopathy was named after an austrain ophthalmologist, othmar purtscher. Purtscher retinopathy american academy of ophthalmology. Ideal sources for wikipedia s health content are defined in the guideline wikipedia. Fundus examination of left eye revealed extensive peripapillary white retinal patches purtchers fleckens associated with peripapillary hemorrhage with normal retinal periphery typically suggestive of unilateral purtschers retinopathy. Two similar cases of purtscher s re nopathy with fundus. Current pharmacologic treatment and emerging strategies pdf author michael w. The ophthalmological picture is one of ischaemia at the posterior pole with white patches of oedema and haemorrhages concentrated around the optic disc. After slit lamp examination and funduscopy purtschers retinopathy was diagnosed.
Wed like to understand how you use our websites in order to improve them. Hemolytic uremic syndrome associated with purtscherlike. Its unclear pathophysiology determines an uncertain treatment strategy, but a meticulous followup is compulsory in order to avoid its severe complications. The characteristic finding in the fundus is the presence of multiple purtscher flecken. Purtschers retinopathy after airbag injury, six month. Purtscherlike retinopathy is a rare and severe angiopathy that begins within some hours to some days after the onset of the. Purtscherlike retinopathy associated with dermatomyositis.
Purtscher retinopathy is a hemorrhagic and vasoocclusive vasculopathy, which, in 1912, was first described as a syndrome of sudden blindness associated with severe head trauma. The clinical features of purtscherlike retinopathy include varying degrees of visual loss associated with multiple patches of superficial retinal whitening, resembling cotton wool spots, and retinal hemorrhages surrounding the optic disk. These patients had findings of multiple white retinal patches and retinal hemorrhages that. Hemorrhage in diabetic retinopathy twoyear results of a randomized trial diabetic retinopathy vitrectomy report 2 the diabetic retinopathy vitrectomy study research group arch ophthalmol. Calhoun, department of ophthalmology, mayo clinic jacksonville, florida imaging device fundus camera description 19yearold female who just recently gave birth to. Diabetic eye disease american diabetes association. Purtscher retinopathy and purtscherlike retinopathy. Purtscher s retinopathy, due to microembolizations in the choroidal and retinal arterioles.
Purtscherlike retinopathy associated with acute pancreatitis was first described in 1975 by inkeles and walsh. To report a rare case of bilateral purtscherlike retinopathy in a chinese female patient. Purtschers retinopathy is an occlusive microangiopathy associated with severe head trauma. Usually associated with severe head injuries, it may also occur with other types of trauma, such as long bone fractures, or with several nontraumatic systemic diseases. Purtschers retinopathy likely involves complex pathophysiology, with several contributing factors, including complementmediated aggregates, fat, air, fibrin clots and platelet clumps. Purtscherlike retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complementmediated leukoembolization. Purtscher like retinopathy is a rare and severe angiopathy that begins within some hours to some days after the onset of the systemic disease and is characterized by confluent cottonwool spots in the posterior pole, few intraretinal hemorrhages, and purtscher flecken in the acute phase. Diabetic retinopathy dr is a vascular disease of the retina which affects patients with diabetes mellitus. Purtschers retinopathy is an occlusive vasculopathy which, in 1912, was first described by dr. Purtschers retinopathy is a medical condition characterized by sudden and possibly severe visual impairment, in the setting of prior extraocular trauma or other systemic, nontraumatic pathologies. Purtschers retinopathy is characterized by sudden visual loss in severely traumatized patients and is associated with multiple areas of superficial retinal whitening. These patients had findings of multiple white retinal patches and retinal hemorrhages that were associated with severe vision loss. The earliest case was reported by otmar purtscher in 1910, which described a man who suffered cranial trauma after falling out of a tree. Purtscherlike retinopathy associated with pancreatic.
The systemic complications of diabetes include retinopathy eyes, nephropathy. Purtscherlike retinopathy is associated with retinal hemorrhages and ischaemia probably. It is most often seen after trauma but commonly associated with other causes. Purtscher retinopathy is a rare condition that occurs in patients with a history of trauma distant from the eyes.