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https://doi.org/10.21860/medflum2019_218804
Purtscher’s retinopathy: case report
Tea Čaljkušić-Mance
; Klinika za oftalmologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Lana Kostić
; Klinika za oftalmologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Damir Kovačević
; Klinika za oftalmologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Zvjezdana Alpeza-Dunato
; Klinika za oftalmologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Tamara Mišljenović-Vučerić
; Klinika za oftalmologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Goran Pelčić
; Klinika za oftalmologiju, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Martina Brumini
; Dom zdravlja Primorsko-goranske županije, Čabar, Hrvatska
Abstract
Aim: To present a case of Purtscher's retinopathy, rare haemorrhagic and vasoocclusive vasculopathy characterized by sudden blindness associated with severe head trauma with non-ocular trauma. It can occur in the complete absence of trauma and the term Purtscher-like retinopathy is used. In most cases it occurs bilaterally, less common unilateral occurence. Since there are still no official guidelines for Purtscher's retinopathy treatment, it represents a challenge. Case report: A 28-year-old male patient who had head trauma secondary to motorcycle accident was referred to our Clinic two days after the trauma for left unilateral visual loss. The patient underwent a detailed ophthalmological examination with no remarkable signs on the right eye and changes of optic nerve head and retinal hemorrhages, multiple white retinal patches (Purtscher's flecken) and cotton wool spots on the left eye. The next step including orbital computerized tomography , macular and optic nervae head optic coherent tomography, fluorescein angiography and perimetry was performed and the patient was finally diagnosed as Purtscher's retinopathy. After consultation with neurosurgeon the patient was treated with pulse methylprednisolone. Almost complete recovery of vision and retinal changes was achieved in 3 months. Conclusions: Purtscher retinopathy is a relatively rare disease; unilateral appearance is less common. There are no exact guidelines for the treatment, some authors cite improvement after therapy with methyl-prednisolone, and some have recorded a certain degree of recovery without treatment. It is necessary to monitor systematically the cases that arise and exchange experiences for the purpose of more precise determination of adequate, possibly new, therapies.
Keywords
methylprednisolone; retinal hemorrhages; retinopathy; trauma
Hrčak ID:
218804
URI
Publication date:
1.6.2019.
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