Purtscher-Like Retinopathy in a Patient With Milk-Alkali Syndrome and Pancreatitis

Abstract

Purpose: To report a case of Purtscher-like retinopathy in a patient with milk-alkali syndrome and pancreatitis.Methods: Case report and review of the literature.Results: A 46-year-old woman presented with decreased vision following discharge from the intensive care unit, where she had been admitted for milk-alkali syndrome secondary to long-term calcium supplementation and over-the-counter antacid use, and pancreatitis. Dilated examination showed ischemic retinal whitening and retinal hemorrhages in the posterior pole bilaterally consistent with Purtscher-like retinopathy. Over three months, the retinopathy resolved and her vision improved.Conclusion: Milk-alkali syndrome is the clinical triad of hypercalcemia, renal failure, and metabolic alkalosis and occurs secondary to the consumption of large amounts of calcium and alkali. The hypercalcemia associated with milk-alkali syndrome may cause pancreatitis, which can lead to Purtscher-like retinopathy.

Ophthalmic Injuries in Sailors and Sea Workers – Pathomechanism and Treatment

“…Purtschers retinopathy retinal findings are cotton-wool spots, retinal hemorrhages, optic disc oedema and Purtscher flecken -retina whitening. It can also be associated with acute pancreatitis as a result of trauma [24]. Currently there are no official evidence based guidelines for treatment of Purtscher retinopathy.…”