Sub tenons triamcinolone for purtschers like retinopathy. Purtscherlike retinopathy with serous macular detachment. Purtschers retinopathy an overview sciencedirect topics. Purtscher retinopathy was first described in 1910 by otmar purtscher 1 in a man who fell from a tree and suffered cranial trauma. In acute pancreatitis, purtscher s retinopathy was described for the first time in 1975 4.
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 14. Purtscherlike retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complementmediated leukoembolization. Given these findings, the diagnosis of retinal ischemia due to suspected purtscherlike retinopathy was made. Fluorescein angiography revealed mild macular nonperfusion in the right eye and extensive macular nonperfusion in the left eye. Purtscherlike retinopathy caused by acute pancreatitis.
Purtschers retinopathy is an occlusive microangiopathy associated with severe head trauma. Purtscher like retinopathy has a similar presentation in the fundus but is not associated with trauma. Purtscher like retinopathy has been rarely described during postpartum period in patients with preeclampsia. Subtenons triamcinolone for purtscherslike retinopathy. Given the patients history and retinal findings, he was diagnosed with purtschers retin opathy, od. Purtscher described a retinopathy associated with nonocular compression injuries which is now called purtscher retinopathy. It was first described in 1910 by otmar purtscher 1 in. A 65yearold male presented with acute onset of vision loss for 2 weeks. Purtscherlike retinopathy presented a honeycomblike. Purtscher retinopathy purtscher retinopathy is a form of retinopathy. Purtscherlike retinopathy associated with high altitude travel. Purtscher s retinopathy is a rare condition, seen in patients with a history of trauma. A diagnosis of purtscher like retinopathy was made, and observation was recommended. It is characterized by ophthalmoscopic alterations of the ocular fundus including a whitening of the inner retina, retinal hemorrhages, and dilated retinal veins.
Current pharmacologic treatment and emerging strategies pdf author michael w. To report the fundus manifestations and spectraldomain optical coherence tomographic sdoct features of dengue fever presenting as purtscher like retinopathy. Purtscher s retinopathy traumatic retinal angiopathy frequently following head or chest injuries should be considered as a differential diagnosis in cases where visual loss is associated with multiple traumas. Purtscher retinopathy is characterized by sudden, usually bilateral visual loss in severely traumatized patients and involves multiple areas of superficial reti. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. It can threaten vision, leading to temporary or permanent blindness. The imaging confirmed the findings of purtscher retinopathy with ischemic whitening of the retina and retinal hemorrhages and thickened inner retina on oct. An unusual ocular complication, with sudden and severe loss of vision, is purtscher s retinopathy 2 3.
Purtscher retinopathy, described in the early twentieth century from ophthalmoscopic findings in patients with head injury in the absence of direct eye damage, is a. It is due to the activation of complement and agglutination of red blood cells within retinal vessels. Purtscher retinopathy is a haemorrhagic and vasoocclusive vasculopathy and was first described as a syndrome of sudden blindness associated with severe head trauma. Purtscher retinopathy is caused by microembolisation of retinal and choroidal arterioles by fat emboli after severe trauma and is characterised by retinal ischaemia and haemorrhages. Purtschers retinopathy is characterized by sudden visual loss in severely traumatized patients and is associated with. When there is a nontraumatic etiology, the correct. There was retinal capillary dropout nasal to the optic nerve head and peripheral to the vascular arcades in both eyes. 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.
Purtscher s retinopathy is an occlusive microvasculopathy associated with trauma. Purtscher like retinopathy as an initial presentation of thrombotic thrombocytopenic purpura. Purtscher retinopathy and purtscherlike retinopathy eyewiki. It provides information about diabetic retinopathy and answers questions about the cause and symptoms of this progressive eye disease. Purtscher like retinopathy following valsalva maneuver effect. It is a rare and severe angiopathy found in conditions such as acute pancreatitis.
Purtschers retinopathy is traumainduced embolization of retinal vasculature likely leukocyte, platelet, fibrin, or fat emboli, with infarction of the nerve fiber layer. The characteristic finding in the fundus is the presence of multiple purtscher flecken. Purtscherlike retinopathy as an initial presentation of. Purtschers retin opathy 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 retinopathy generally occurs as a result of cranial trauma or thoracic compression. Purtscher s retinopathy, due to microembolizations in the choroidal and. Pathogenesis and neuroprotective treatment in purtschers. Purtscherlike retinopathy as a rare presentation of. The diagnosis of purtscher s and purtscher like retinopathies pur is clinical, with a presentation that usually includes sudden vision loss of variable severity, hours to days after the causal pathology. 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. A 53 year old female diagnosed with adultonset stills disease aosd presented to us with findings consistent with purtscher like retinopathy in both eyes, with 2070 visual acuity in the right eye and 2020 visual acuity in the left eye.
A similar clinical presentation called purtscher like retinopathy is associated with systemic diseases instead of trauma. It is caused by complement activation after acute crushing injuries to the head or thorax. Acute pancreatitis is one of the most common causes of purtscher retinopathy, accounting for a third of cases in a recent uk and ireland survey. Purtscher retinopathy and necrotizing vasculitis with.
Another case of purtscher like retinopathy has been described in a patient with hellp syndrome during antepartum. Purtschers retinopathy after fracture dislocation of. Purtscher described sudden blindness in patients with severe head trauma due to a remote retinopathy, characterised by bilateral retinal haemorrhages, cotton wool spots, and optic disc swelling seen on fundoscopy. The author noted multiple abnormalities on fundoscopic examination, including retinal hemorrhage and retinal whitening, associated with diminished visual acuity. Acute fundus abnormalities in purtschers retinopathy include purtscher flecken, cottonwool spots, retinal hemorrhage.
Purtscher retinopathy is the appearance of cotton wool spots, hemorrhages, and retinal edema located predominantly around the optic disc. Purtscher retinopathy and purtscherlike retinopathy. One of the most complicated injuries to assess are eye injuries and specifically, traumatic retinopathies. Pdf purtscherlike retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complementmediated. A wellillustrated and comprehensive analysis of the treatment of diabetic retinopathy, this book covers.
Purtscher s retinopathy is a microvascular occlusive disease initially described as retinal edema, cotton woollike exudation, and hemorrhages occurring after severe head trauma. Subtenons triamcinolone for postpartum purtscherslike. Pdf on dec 1, 2014, anil kumar verma and others published purtschers retinopathy find, read and cite all the. We present an unusual combination of serous macular detachment coexisting with purtscher like retinopathy as a complication of preeclampsia during postpartum period. Purtscher like retinopathy includes the nontraumatic causes of this retinal disease, which is often.
Purtscher like retinopathy associated with anorexia nervosa. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Purtschers retinopathy is a disease where part of the eye retina is damaged. Pathogenesis and neuroprotective treatment in purtscher s retinopathy anguor wang, mayyung yen and jornhon liu department of ophthalmology, taipei veterans general hospital, national yangming university, taipei, taiwan, republic of china. Purtschers retin opathy is a medical condition characterized by sudden and possibly severe visual impairment, in the setting of prior extraocular trauma or other systemic, nontraumatic pathologies. The fundus characteristics are purtscher flecken, which are multiple cotton wool spots of varying sizes. 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. Fundus examination revealed cottonwool spots, retinal haemorrhage, and purtscher flecken spread around the optic disc in the right eye. These patients had findings of multiple white retinal patches and retinal hemorrhages that were associated with severe vision loss. To report a rare case of bilateral purtscher like retinopathy in a chinese female patient. Purtscher like retinopathy in acute pancreatitis is an indicator of multiorgan failure and is often associated with a fatal outcome.
The retinopathy that now bears his name was discovered in two severely traumatized patients with head injuries purtscher 1912. Angiopathia retinae traumatica was first described by dr. Purtscherlike retinopathy presented a honeycomblike pattern in. Generally purtscher like retinopathy has a favorable prognosis but this case resulted in permanent loss of vision stewart et al 2007. Currently, there is no definitive treatment for postpartum purtschers like retinopathy. What you should know this booklet is for people with diabetic retinopathy and their families and friends.
However, her visual acuity did not recover completely right, 2040, left, 2025, although the underlying pancreatitis had been treated successfully. Refer patient promptly with acute visual complaints in setting of trauma, pancreatitis. Purtscherlike retinopathy in adultonset stills disease. Purtscher like retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complementmediated leukoembolization. Purtscher s retinopathy was first described in the literature in 1912 and was associated with trauma, thoracic compression, and bone fractures. Institute of clinical medicine, national yangming university, taipei, taiwan, republic of. Purtscherlike retinopathy associated with dermatomyositis. Purtschers retin opathy was first described in 1910 by otmar purtscher, in a patient with severe head trauma. Purtscher s retinopathy is a disease where part of the eye is damaged. Purtscherlike retinopathy associated with cerebro or.
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