scholarly journals Purtscher-Like Retinopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Rita Massa ◽  
Carolina Vale ◽  
Mafalda Macedo ◽  
Maria João Furtado ◽  
Miguel Gomes ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Anterior Segment ◽  
Peripheral Retina ◽  
Cotton Wool ◽  
Fiber Layer ◽  
Retinal Hemorrhages ◽  
Nerve Fiber Layer Thickness ◽  
Cotton Wool Spots ◽  
The Right

Purtscher-like retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complement-mediated leukoembolization. It is a rare and severe angiopathy found in conditions such as acute pancreatitis.Case. We present a case of a 53-year-old man who presented with a Purtscher-like retinopathy associated with the development of acute pancreatitis in the context of a Klatskin tumour (a hilar cholangiocarcinoma). The ophthalmologic evaluation revealed the best corrected visual acuity (BCVA) of 20/32 in the right eye (RE) and of 20/40 in the left eye (LE); biomicroscopy of anterior segment showed scleral icterus and fundoscopy revealed peripapillary cotton-wool spots, optic disc edema, and RPE hypo- and hyperpigmentation in the middle peripheral retina in both eyes with an intraretinal hemorrhage in the LE. 15 months after the initial presentation, without ophthalmological treatment, there was an improvement of BCVA to 20/20 in both eyes and optical coherence tomography (OCT) revealed areas of reduction of retinal nerve fiber layer thickness corresponding to the previous cotton-wool spots.Conclusion. Purtscher-like retinopathy should not be neglected in complex clinical contexts. Its unclear pathophysiology determines an uncertain treatment strategy, but a meticulous follow-up is compulsory in order to avoid its severe complications.

scholarly journals A Case of Bilateral Retinal Hemorrhage with Cotton Wool Spot Following Viper Bite

2015 ◽  
Vol 14 (3) ◽  
pp. 297-298
Author(s):  
Subhasis Jana ◽  
Saumen Kumar Chaudhuri ◽  
Purban Ganguly ◽  
Sumi Ghorai
Keyword(s):  
Degradation Products ◽  
Medical Science ◽  
Retinal Hemorrhage ◽  
Fundus Examination ◽  
Cotton Wool ◽  
Retinal Hemorrhages ◽  
Cotton Wool Spots ◽  
Fibrin Degradation Products ◽  
History Of

A 38 years male, admitted in the department of Internal Medicine with a history of snake bite in his left lower leg during agriculture work. He was treated with anti snake venom after admission. He had history of dimness of vision in both eyes. On examination, swelling and subcutaneous hemorrhage was noted in his left leg. His best corrected visual acuity (BCVA) was 6/60 in the both eyes. Fundus examination with 90 D lens and Indirect Ophthalmoscopy of both eyes showed retinal hemorrhage with cotton wool spots. Blood tests revealed increased titers of D-dimer and fibrin degradation products. The patient was followed up regularly at 2 weeks interval and BCVA and Fundus examination was carried out. At the end of 10 weeks, retinal hemorrhages had significantly cleared in both eyes with improvement of vision in both eyes (BCVA of right eye at last follow-up 6/6 and left eye 6/9).Bangladesh Journal of Medical Science Vol.14(3) 2015 p.297-298

Optical coherence tomography angiography characterization of acute and late stage Purtscher retinopathy

2018 ◽  
Vol 28 (4) ◽  
pp. NP1-NP6 ◽  
Author(s):  
Pedro Gil ◽  
Miguel Raimundo ◽  
João P Marques ◽  
João Póvoa ◽  
Rufino Silva
Keyword(s):  
Optical Coherence Tomography ◽  
Late Stage ◽  
Optical Coherence Tomography Angiography ◽  
Road Traffic ◽  
Optical Coherence ◽  
Cotton Wool ◽  
Fiber Layer ◽  
Cotton Wool Spots ◽  
Purtscher Retinopathy

Purpose: To report a case of Purtscher retinopathy imaged with optical coherence tomography angiography. Methods: Case-report. Left eye fundoscopic examination in a 21-year old male after a road traffic accident with chest compression revealed multiple peri-papillary cotton-wool spots and intra- and pre-retinal hemorrhages. A diagnosis of Purtscher retinopathy was assumed. Results: In both the superficial and deep retinal plexuses, acute stage optical coherence tomography angiography identified multiple irregular areas of capillary non-perfusion that extended beyond the clinically visible peri-papillary cotton-wool spots. At 5-month follow-up, despite the clearing of visible cotton-wool spots, there were still permanent areas of irregular capillary non-perfusion and inner retina atrophy. These sequelae, along with a decrease in the peri-papillary retinal nerve fiber layer thickness, were consistent with a suboptimal visual outcome and a dense inferior arcuate scotoma. Conclusion: Baseline and follow-up optical coherence tomography angiography was able to detect, quantify, and map focal microvascular abnormalities at the level of the superficial and deep inner retinal vascular plexuses. These lesions were consistent with late stage structural and functional sequelae, conferring them prognostic value.

scholarly journals Ocular imaging findings of bilateral optic disc pit in a child

2013 ◽  
Vol 5 (2) ◽  
pp. 258-261 ◽  
Author(s):  
Abdullah Ozkaya ◽  
Z Alkin ◽  
AT Taylan ◽  
A Demirok
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Nerve Fiber ◽  
Optic Disc ◽  
Anterior Segment ◽  
Rare Condition ◽  
Optic Disc Pit ◽  
Fiber Layer ◽  
Retinal Nerve Fiber

Background: To report a rare condition of bilateral optic disc pit in a child. Case description: A ten-year-old female was admitted with a complaint of headache. Visual acuity was 20/20 in both eyes (OU). Anterior segment examination was normal in OU. Fundus examination revealed optic disc pit (ODP) located temporally with a diameter of 1/5 disc diameter in OU. Intraocular pressure was within normal limits in both eyes. Macular optical coherence tomography (OCT) showed a loss of retinal tissue at the site corresponding to the ODP in both eyes. Retinal nerve fiber OCT revealed decreased RNFL thickness at the temporal side of the optic nerve, corresponding to the ODP in both eyes. The patient and patient’s parents were informed about the disease and called for follow-up examinations every 6 months. In addition, the family was informed about optic pit maculopathy (OPM) and, they were told to return immediately if the patient ever complained of decreased vision in either of her eyes. After a follow-up period of 12 months, visual acuity remained stable, and no complications secondary to ODP were detected. Conclusion: Optic disc pit is diagnosed incidentally unless it is complicated with OPM. The retinal nerve fiber layer thickness is decreased at the side of the optic nerve corresponding to the ODP. Nepal J Ophthalmol 2013; 5(10): 258-261 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8739

scholarly journals Eye manifestations of COVID-19. Step one

2021 ◽  
Vol 9 (1) ◽  
pp. 34-42
Author(s):  
P.A. Bezdetko
Keyword(s):  
Ganglion Cells ◽  
Severe Pneumonia ◽  
Cotton Wool ◽  
Ocular Complications ◽  
Retinal Hemorrhages ◽  
The Past ◽  
Cotton Wool Spots ◽  
Ocular Surface Diseases ◽  
Plexiform Layers ◽  
Papillomacular Bundle

In the past few months, medical practice has changed faster than in the past few decades. This was due to the coronavirus disease (COVID-19) pandemic. Ophthalmic problems are most significant in patients with severe pneumonia. The exact incidence of conjunctivitis in COVID-19 patients ranges from 0.8 to 31.6 %. Optical coherence tomography demonstrated hyperreflective lesions at the level of ganglion cells and inner plexiform layers, more pronounced in the papillomacular bundle of both eyes. Retinal hemorrhages were found in at least one eye in five patients (9.25 %), cotton wool spots were detected in four people (7.4 %), and drusen was observed in six patients (11.1 %). On examination of the fundus, dilated veins were revealed in 15 patients (27.7 %), tortuous vessels — in 7 individuals (12.9 %). The literature reports describe patients who were diagnosed with COVID-19 after the detection of diplopia and ophthalmoparesis. The incidence of ocular complications in patients of the intensive care units in different studies ranges from 3 to 60 %. The most common manifestations are ocular surface diseases, increased intraocular pressure, and disorders of the anterior and posterior segments.

scholarly journals A Case Study on Retinoblastoma Associated Orbital Cellulitis

2021 ◽  
pp. 91-97
Author(s):  
Sagili Chandrasekhara Reddy ◽  
Bina Sharine Menon
Keyword(s):  
Anterior Segment ◽  
Oral Prednisolone ◽  
Detailed Examination ◽  
Orbital Cellulitis ◽  
Eye Drops ◽  
Upper Eyelid ◽  
Bilateral Retinoblastoma ◽  
Pediatric Oncologist ◽  
The Right

A 20-months-old male child was brought to the Eye clinic with swelling of right upper eyelid, discharge sticking the eyelids in the right eye and redness in both eyes of three days duration. On detailed examination of anterior segment and fundus, the diagnosis of bilateral retinoblastoma with conjunctivitis was made. The conjunctivitis was cured with ciprofloxacin eye drops and eye ointment. CT scan of orbits and brain confirmed the diagnosis of retinoblastoma with calcification in both eyes. Optic nerve on both sides was normal and there was no metastasis in the brain. Since it was a bilateral case of retinoblastoma, chemoreduction followed by enucleation in the right eye, and salvaging the left eye with chemotherapy in order to save the vision was planned. Intravenous triple drug chemotherapy with carboplatin, etoposide and vincristine (six cycles) was started by pediatric oncologist in pediatric ward. After two weeks of completing the first cycle of treatment, enucleation of right eye was done. Postoperative period was uneventful. The chemotherapy was continued. The child developed marked swelling of left upper eyelid few days before the sixth cycle of chemotherapy. Examination of left eye showed signs of aseptic orbital cellulitis which was treated with oral prednisolone and topical eye drops of combination of gentamycin and dexamethasone. The inflammatory signs subsided completely in ten days time. The sixth cycle of chemotherapy was completed. On the follow up visit two weeks after discharge, the left eye ball was normal. In the first follow up, the child could pick up the toys thrown in front of him. Unfortunately the child defaulted follow up. Retinoblastoma should be excluded in all young children with orbital cellulitis because misdiagnosis is life threatening.

scholarly journals A Rare Case of Unilateral Progressive Cataract in a Young Patient Receiving Topiramate

2020 ◽  
Vol 11 (2) ◽  
pp. 276-281 ◽  
Author(s):  
Tanuja Kate ◽  
Rajiv Choudhary ◽  
Jyoti Singhai ◽  
Navita Pathak
Keyword(s):  
Young Patient ◽  
Past History ◽  
Anterior Segment ◽  
Acute Angle ◽  
Angle Closure ◽  
Rapid Progression ◽  
Topical Steroids ◽  
Acute Angle Closure ◽  
The Right

This case report presents an instance of unilateral cataract formation and its rapid progression following topiramate-induced bilateral acute angle closure. An 18-year-old female diagnosed with acute angle closure in both eyes had started treatment on the previous day at another healthcare facility. The patient presented with complaints of pain, sudden diminution of vision, excessive watering, and photophobia (both eyes) and reported the use of topiramate for headache for 10 days. There was no past history of decreased vision, trauma, uveitis, or use of steroids. Topiramate-induced bilateral secondary angle closure attack was the presumptive diagnosis. Topiramate use was stopped, and antiglaucoma drugs, topical cycloplegic, and topical steroids were started. On 1-day follow-up, clearer cornea and peripheral anterior capsular lenticular opacity of the right eye were observed. Gonioscopy showed closed angles. Anterior segment optical coherence tomography showed forward movement of the iris-lens diaphragm and closed angles. B-scan showed ciliochoroidal effusion in the right eye and normal left eye. At 2-month follow-up, formed anterior chamber and posterior subcapsular cataract in the right eye were seen. There were no lenticular changes in the left eye. Definite progression of cataract from day-1 to 2-month follow-up was seen in the right eye. To our knowledge, this is the first report of the rapid progression of cataract following topiramate-induced secondary angle closure in a young patient warranting surgical intervention.

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