Spectral Domain-Optical Coherence Tomography and Fundus Autofluorescence Findings in a Case of Purtscher-Like Retinopathy

Abstract

Spectral domain-optical coherence tomography and autofluorescence are sensitive and noninvasive imaging modalities to evaluate retinal alterations after Purtscher-like retinopathy. Spectral domain-optical coherence tomography confirms that ischemia causes an alteration primarily in the inner retinal layers, but the process also involves the outer retinal layers.

Optical Coherence Tomography Angiography of Purtscher Retinopathy after Severe Traffic Accident in 16-Year-Old Boy

“…The funduscopic findings include whitening of the retina, multiple cotton wool spots, and bleeding of different sizes. The retinal changes are explained by acute ischemia [ 1 , 2 ].…”

Simultaneous paracentral acute middle maculopathy and purtscher-like retinopathy after acute febrile illness

“…6,7 In other less-recent reports of Purtscher-like retinopathy that described a hyper-reflectivity in middle and outer retinal layers in their OCT findings (before describing PAMM and AMN as distinct entities,) this hyper-reflectivity similarly resolved spontaneously after several weeks of follow-up. 8,9 This hyper-reflectivity in middle and outer retinal layers cannot be explained by cotton wool spots of Purtscher-like retinopathy, because cotton wool spots are caused by superficial retinal layers ischemia. It seems that these cases of Purtscher-like retinopathy also were associated with PAMM and AMN.…”

Fundus autofluorescence in blunt ocular trauma

“…In this report, we describe hypoautofluorescence in the areas corresponding to Purtscher's spots, hyperautofluorescence in veins affected by ischemia during the acute phase of retinopathy, and a granular pattern of hyperautofluorescence and hypoautofluorescence in the region previously affected by the Purtscher's spots after the retinopathy had been resolved (10) . Contrary to this finding, FAF imaging of the patient described in the present study showed hypoautofluorescence in the areas corresponding to intraretinal hemorrhage and mild hyperautofluorescence surrounding the macular region, corresponding to the sites where Purtscher's spots were observed.…”

“…Only 1 report of a Purtscher-like retinopathy case (following pancreatitis) was found in the literature, which described the results of (10) . In this report, we describe hypoautofluorescence in the areas corresponding to Purtscher's spots, hyperautofluorescence in veins affected by ischemia during the acute phase of retinopathy, and a granular pattern of hyperautofluorescence and hypoautofluorescence in the region previously affected by the Purtscher's spots after the retinopathy had been resolved (10) .…”