J Korean Ophthalmol Soc.  2012 Sep;53(9):1341-1345. 10.3341/jkos.2012.53.9.1341.

Spontaneously Resolved Purtscher's Retinopathy within 24 Hours: Case Report and OCT Review

• Lee MY
• Park JY
• Seo WM

• KMID: 2216090
• DOI: http://doi.org/10.3341/jkos.2012.53.9.1341

Abstract

PURPOSE
To report a case of unilateral Purtscher's retinopathy that spontaneously resolved within 24 hours.
CASE SUMMARY
A 54-year-old man presented with decreased visual acuity in his left eye after a vehicle accident. When the accident occurred, his chest region was compressed by the safety belt. The case was diagnosed with Purtscher's retinopathy based on fundus examination, flourescein angiography (FAG) and optical coherent tomography (OCT). At presentation, the best corrected visual acuity (BCVA) was 0.3 in the affected eye. Tiny Purtscher-flecken and macular edema were observed but there was no sign of retinal hemorrhage. Immediately after the trauma, OCT detected abnormally increased hyperreflectivity in the nerve fiber layer and ganglion cell layer, severe cystoid edema and serous foveal detachment. Without any treatment, BCVA was improved to 1.0 within 12 hours. Recovery of visual acuity was followed by improvement of abnormal hyperreflectivity in the nerve fiber layer, cystoid macular edema and serous foveal detachment.
CONCLUSIONS
The authors of the present study report a dramatically resolved unilateral Purtscher's retinopathy after blunt chest trauma.

Keyword

Blunt chest trauma; Optical coherent tomography; Purtscher's retinopathy

MeSH Terms

Angiography
Edema
Eye
Ganglion Cysts
Humans
Macular Edema
Middle Aged
Nerve Fibers
Retinal Hemorrhage
Thorax
Visual Acuity

Figure

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  Figure 1 (A) At presentation, severe cystoid macular edema (asterisk) in fovea and hyper-reflectivity (arrow) in the nerve fiber layer and ganglion cell layer. (B) 7 hours later, cystoid edema much improved. (C) 12 hours later, cystoid edema disappeared and only foveal serous detach is shown. (D) 20 hours later, nearly normal OCT finding but mild edema persists in the outer nuclear layer.

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  Figure 2 (A) At presentation, loss of foveal reflex and small Purtscher-flecken (black arrow). (B) Red-free image shows retinal nerve fiber damage (yellow arrows).

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  Figure 3 (A) On fluorescein angiography, minimal fluorescein pooling on the fovea at the arteriovenous phase. (B) Arteriolar stain is shown at the late venous phase.

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