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Purtscher's retinopathy: epidemiology, clinical features and outcome
  1. Ashish Agrawal (ashish5632{at}yahoo.co.uk),
  2. Martin McKibbin (martin.mckibbin{at}leedsth.nhs.uk)
  1. Manchester Royal Eye Hospital, United Kingdom
  2. St James's University Hospital, Leeds, United Kingdom

    Abstract

    Aims: To study the incidence, systemic associations, presenting features and natural history of Purtscher’s retinopathy in the United Kingdom and Ireland.

    Methods: Cases were collected prospectively by active surveillance through the British Ophthalmological Surveillance Unit. Clinical details were obtained using an incident questionnaire, with follow-up at 1 and 6 months.

    Results: Clinical details were obtained for 15 cases in 1 year. These were associated with road traffic accident in 6 cases, chest compression in 6 cases and acute pancreatitis in 3 cases. All cases were symptomatic and presented with loss of visual acuity, visual field or a combination. Bilateral involvement was noted in 9 cases. The acute retinal signs of cotton wool spots, retinal haemorrhage and Purtscher flecken cleared within one month in 26% of eyes and within 6 months in all eyes. The most common chronic signs were optic disc pallor and atrophy of the retinal pigment epithelium. Without treatment, 50% of eyes improved by at least 2 Snellen lines at final follow-up and 23% improved by at least 4 Snellen lines. Only 1 of the 24 eyes had a final acuity worse than that recorded at presentation.

    Conclusion: Purtscher's retinopathy is a rare but sight threatening eye condition, most commonly seen in young or middle-aged males and after trauma. Spontaneous visual recovery of at least 2 Snellen lines is seen in half of the cases.

    • Pancreatitis
    • Purstcher
    • Purtscher's retinopathy

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