Systematic review of Purtscher’s and Purtscher-like retinopathies

Miguel, Ana; Henriques, Filipe; Azevedo, Luís Filipe; Loureiro, Alfredo; Maberley, David

doi:10.1038/eye.2012.222

Cited by 185 publications

(260 citation statements)

References 51 publications

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“…The deterioration of vision may occur directly after the injury or within 24-48 h after the injury [3]. In the presented case, the deterioration was observed on the first day after injury.…”

Section: Discussionmentioning

confidence: 72%

“…Purtscher retinopathy is a vision-threatening condition most frequently observed in young or middleaged males as a consequence of head or chest injuries [3]. A considerable number of PR cases refer to retinopathies that develop after traffic accidents [6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…At present, microembolisation of the retinal and choroidal vessels with the development of ischaemic zones is considered the most probable cause of occurrence of PR, as well as Purtscher-like rethinopahy [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Purtscher’s retinopathy – case report and literature review

Roskal-Wałek¹,

Gierada²,

Mackiewicz³

2017

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Purtscher's retinopathy is a vision-threatening state that most frequently occurs in young or middle-aged males after head or chest injury. The main symptom reported by patients is sudden, painless deterioration of vision, which can affect one or both eyes. In most patients, the changes observed in the fundus of the eye resolve within several months, and visual acuity returns to the state from before the injury. The occurrence of ischaemic changes concerning the macula or optic nerve disc may cause permanent deterioration of visual acuity. We present a case of a 43-year-old male with Purtscher's retinopathy after a traffic accident. The article discusses clinical image, aetiology, and the current state of knowledge concerning the possibilities in diagnostics and treatment of Purtscher's retinopathy. StreszczenieRetinopatia Purtschera jest stanem zagrażającym widzeniu, występującym najczęściej u mężczyzn w młodym lub średnim wieku w następstwie urazów głowy lub klatki piersiowej. Głównym objawem zgłaszanym przez pacjentów jest nagłe, bezbolesne pogorszenie widzenia, które może dotyczyć jednego lub obu oczu. U większości pacjentów zmiany obserwowane na dnie oka ustępują w ciągu kilku miesięcy i ostrość wzroku wraca do stanu sprzed urazu. Wystąpienie zmian niedokrwiennych dotyczących plamki lub tarczy nerwu wzrokowego może skutkować trwałym pogorszeniem ostrości wzroku. W pracy przedstawiono przypadek retinopatii Purtschera u 43-letniego pacjenta po wypadku komunikacyjnym. Opisano obraz kliniczny, etiopatogenezę oraz aktualny stan wiedzy dotyczącej możliwości diagnostyki i leczenia retinopatii Purtschera.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Purtscher’s retinopathy – case report and literature review

Roskal-Wałek¹,

Gierada²,

Mackiewicz³

2017

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“…Purtscher flecken are considered pathognomonic 4 and occur in 63% of Purtscher and Purtscher-like retinopathies (PuR). 3 Nesmith et al report the first case of PuR with improvement of visual acuity, fundoscopic signs, and macular edema after the injection of intravitreal bevacizumab. Anti-VEGF agents may be of value considering PuR's proposed pathological mechanisms, namely in endothelial dysregulation 5 and in precapillary arterioles' occlusion with altered retinal microvascular permeability.…”

mentioning

confidence: 99%

“…6 However, there must be caution before concluding that bevacizumab is useful in PuR because spontaneous improvement is frequent. In a systematic review regarding Purtscher and Purtscher-like retinopathies, 3 we identified improvement of visual acuity in PuR patients without treatment (there was no statistically significant difference between visual acuity improvement in patients receiving corticosteroids vs no corticosteroids), as well as improvement in OCT findings in 63% of the patients, as normalization of the fundoscopic signs in 40% of the patients with PuR. Observation and treatment of the underlying etiology may continue to be the most reasonable therapeutic option at the moment.…”

mentioning

confidence: 99%