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Purtscher’s retinopathy: epidemiology, clinical features and outcome
  1. Ashish Agrawal1,
  2. Martin McKibbin2
  1. 1
    External Eye Diseases & Refractive Surgery, Manchester Royal Eye Hospital, Manchester, UK
  2. 2
    St James’s University Hospital, Leeds, UK
  1. Mr M McKibbin, Department of Ophthalmology, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK; martin.mckibbin{at}


Aims: To study the incidence, systemic associations, presenting features and natural history of Purtscher’s retinopathy in the UK 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 over 12 months. These were associated with road traffic accidents 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 1 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 men and after trauma. Spontaneous visual recovery of at least 2 Snellen lines is seen in half of the cases.

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  • Competing interests: None.

  • Funding: The study was jointly funded by the British Ophthalmological Surveillance Unit and Yorkshire Eye Research.

  • Abbreviations:

    British Ophthalmic Surveillance Unit


    Early Treatment of Diabetic Retinopathy Study


    road traffic accidents