Purtscher's retinopathy: epidemiology, clinical features and outcome
- Published Online First 7 June 2007
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.