scholarly journals Bilateral severe visual loss in a patient with acute pancreatitis: Purtscher-like Retinopathy

2017 ◽  
Vol 57 (2) ◽  
pp. 50
Author(s):  
Ricardo Evangelista Marrocos de Aragao ◽  
Ieda Maria Alexandre Barreira ◽  
Gustavo Jose Arruda Mendes Carneiro ◽  
Nayara Queiroz Cardoso Pinto ◽  
Talles Peterson Cavalcante Oria ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Visual Loss ◽  
Vision Loss ◽  
Acute Injury ◽  
Cotton Wool ◽  
Retinal Edema ◽  
Severe Visual Loss ◽  
Cotton Wool Spots ◽  
Purtscher Retinopathy ◽  
Active Complement

Purtscher retinopathy is a unilateral or bilateral visual loss following acute injury to the thorax or head. It is characterized by large cotton-wool spots, hemorrhages, and retinal edema. Vision loss may be permanent due to isquemia of the retina, and optic atrophy. Is thought to be a result of injury-induced complement ativation causing granulocyte aggregation and leukoembolization. Other conditions may active complement and may produce similar fundus appearance including acute pancreatitis, collagen-vascular disease, childbirth, and amniotic fluid embolism. Herein, we describe a patient with bilateral permanent visual loss following diagnosis of acute pancreatitis.

Cotton-Wool Spots Associated With Mild Nonprogressive Visual Loss

2015 ◽  
Vol 133 (12) ◽  
pp. 1471 ◽  
Author(s):  
Aristomenis Thanos ◽  
Daniel D. Esmaili ◽  
Dean Eliott
Keyword(s):  
Visual Loss ◽  
Cotton Wool ◽  
Cotton Wool Spots

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 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 Onset and Treatment on Purtscher’s Retinopathy in a Single Eye

2021 ◽  
Author(s):  
Ting Yuan ◽  
Haitong Lian ◽  
Chao Gao
Keyword(s):  
Vision Loss ◽  
Case Reports ◽  
Cotton Wool ◽  
Medical Treatments ◽  
Case Presentation ◽  
Traumatic Injuries ◽  
Chest Injuries ◽  
Purtscher’S Retinopathy ◽  
Cotton Wool Spots ◽  
The Right

Abstract Background:Purtscher’s retinopathy is an occlusive microvasculopathy caused by traumatic injuries, especially like head and chest injuries. The exact mechanism of injury remains unclear, and Most case reports about Purtscher’s retinopathy focused on the symptoms of fundus, and did not provide detailed medical treatments. Case presentation: In this case, the patient suffered suddenly vision loss in the right eye one day after a traffic accident with moderate head and chest injuries. Ocular examinations revealed typical characteristics of cotton wool spots, and minimal intraretinal hemorrhages around the optic disc. 5 different drugs were used in this patient. 15 days after the treatment (corticosteroids and traditional Chinese medicine), the vision of the patient was improved and the symptoms (cotton wool spots, hemorrhages, retinal edema and visual field) were alleviated obviously. Conclusions: Corticosteroids and traditional Chinese medicines used in our case did improve the vision of the patient, and alleviated the symptoms of fundus.

The Association Between Obstructive Sleep Apnea and Cotton-Wool Spots in Nonproliferative Diabetic Retinopathy

2021 ◽  
pp. 247412642198957
Author(s):  
Halward M.J. Blegen ◽  
Grant A. Justin ◽  
Bradley A. Bishop ◽  
Anthony R. Cox ◽  
James K. Aden ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Diabetic Retinopathy ◽  
Sleep Apnea ◽  
Body Mass ◽  
Smoking Status ◽  
Cotton Wool ◽  
Nonproliferative Diabetic Retinopathy ◽  
Cotton Wool Spots ◽  
Obstructive Sleep

Purpose: This work reports the association of obstructive sleep apnea (OSA) and cotton-wool spots (CWS) seen in patients with nonproliferative diabetic retinopathy (DR). Methods: A random sample of patients diagnosed with DR between January 1, 2015 and December 31, 2018, were selected from medical-billing codes. Dilated funduscopic examination findings and medical history were analyzed by reviewing medical records. Results: CWS were present in 12 of 118 patients without OSA, compared with 11 of 32 patients with OSA (10.2% vs 34.4%, respectively; P = .002). OSA was more common in men (68.8%, P = .03) and associated with a higher body mass index (30.0 ± 5.0 without OSA vs 33.6 ± 5.5 with OSA, P < .001). When comparing those with and without OSA, there was no association with age; glycated hemoglobin A1c; stage of DR; insulin dependence; presence of diabetic macular edema; smoking status; or a history of hypertension, hyperlipidemia, cardiovascular disease, or other breathing disorder. Conclusions: The presence of OSA is associated with CWS in patients with DR, as well as male sex and a higher body mass index. Further research is needed to determine the ophthalmologist’s role in the timely referral of patients with CWS for OSA evaluation.

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