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TitelUnilateral Purtscher retinopathy caused by thoracic traumatism
Abstract Nr.P103
DoelTo report a case of a unilateral Purtscher retinopathy after a thoracic traumatism.
MethodesA 17-year-old man complained of a visual loss and scotoma in his right eye within one week after beeing crushed by a tree on his thorax. Visual acuity and fundus examination were performed. In a second step, visual field testing, fluorescein angiography and optical coherence tomography were also performed. There was no treatment instaured
ResultatenVisual acuity improved from 0,8 to 1.0 after 1 month. Fundus examination revealed, at first examination, peri-papillary cotton-wool spots and a few superficials retinal hemorrhages confined in the posterior pole. There was no Purtscher flecken. Visual field indicated a central scotoma. Angiography showed hypofluorescence due to masking effect of the cotton-wool spots and hemorrhages, no capillary occlusion was found. The OCT revealed the cotton-wool spots in the inner retina layer. After 1 month, fundoscopy was almost washed out of any signs described above but central scotoma subsisted.
ConclusiePurtscher's retinopathy is a rare condition that is by definition, correlated to a traumatism, usually thoracic or cranial. Purtscher's like retinopathy includes other etiologies such as acute pancreatitis.
This condition is usually bilateral, some cases are reported to be unilateral. The exact mechanism remains unknown but may include vascular occlusion by emboli, raised intracranial pressure or intrathoracic pressure. No definite guidelines exist as to treat this condition. Corticosteroid are sometimes used but there is no evidence of efficacy.
Auteur 1
NaamSKA
InitialenD
InstituutService d'Ophtalmologie, Cliniques Universitaires Saint-Luc
StadBruxelles, Belgique
Auteur 2
NaamGUAGNINI
InitialenAP
InstituutService d'Ophtalmologie, Cliniques Universitaires Saint-Luc
StadBruxelles, Belgique
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