From the Research
Purtscher retinopathy is a rare ocular condition characterized by sudden vision loss due to multiple areas of retinal whitening and hemorrhages, typically occurring after trauma or severe systemic illness, such as systemic lupus erythematosus (SLE) or acute pancreatitis, as reported in a recent study 1.
Definition and Pathophysiology
Purtscher retinopathy results from embolic occlusion of small retinal vessels, often following traumatic injuries, acute pancreatitis, crush injuries, or other conditions that cause fat or air emboli to enter the circulation. The pathophysiology involves microembolization to the retinal circulation, leading to areas of retinal ischemia and infarction.
Clinical Features and Diagnosis
The clinical appearance of Purtscher retinopathy includes multiple retinal white areas around the optic nerve head and fovea with paravascular clearing and may be related to intraretinal hemorrhages, as described in a case report 2. Diagnosis is made through clinical examination showing the characteristic retinal findings, including cotton-wool spots and Purtscher flecken, which are seen in approximately 55% and 51% of patients, respectively 1.
Management and Treatment
Treatment with rituximab and low-dose interleukin-2 may be considered in patients with Purtscher-like retinopathy associated with SLE, as it has shown good prognosis in a recent case report 3. Management focuses on treating the underlying cause and monitoring for visual improvement, which may occur spontaneously in some patients over weeks to months. Visual prognosis is variable, with some patients experiencing significant recovery while others have permanent vision loss.
Key Points
- Purtscher retinopathy is a rare ocular condition characterized by sudden vision loss due to multiple areas of retinal whitening and hemorrhages.
- It typically occurs after trauma or severe systemic illness, such as SLE or acute pancreatitis.
- Diagnosis is made through clinical examination showing the characteristic retinal findings.
- Treatment with rituximab and low-dose interleukin-2 may be considered in patients with Purtscher-like retinopathy associated with SLE.
- Visual prognosis is variable, with some patients experiencing significant recovery while others have permanent vision loss.