Uma Apresentação típica de Retinopatia de Purtscher

Autores

  • Christophe Pinto Department of Ophthalmology, Hospital de Braga, Braga, Portugal
  • Petra Gouveia Department of Ophthalmology, Hospital de Braga, Braga, Portugal; Department of Ophthalmology, Hospital das Forças Armadas, Porto, Portugal
  • Gil Calvão Santos Department of Ophthalmology, Hospital de Braga, Braga, Portugal; Department of Ophthalmology, CUF Porto, Porto, Portugal

Palavras-chave:

Acuidade Visual, Doenças Retinianas, Retina

Resumo

IMAGE DESCRIPTION

Purtscher’s retinopathy is a rare, sight-threatening retinal disorder associated with numerous types of trauma. It has been firstly described in 1910 by Otmar Purtscher.1,2 Although the exact pathogenesis remains unclear, all clinical features suggest microembolic occlusion of the retinal precapillary arterioles.3 It frequently leads to sudden but reversible visual loss following the precipitating condition. Apart from the treatment of the underlying etiology, no therapeutic guidelines exist.4

A 25-year-old male presented to our emergency department with sudden, unilateral and painless visual loss 1 week after the surgical correction of a lumbar spine fracture due to severe lumbar trauma. Best-corrected visual acuity (BCVA) was 20/200 in the affected eye and fundoscopic examination revealed multiple cotton-wool spots, Purtscher flecken and intraretinal hemorrhages with peripapillary distribution (A). Fundus autofluorescence displayed several hypofluorescent areas (B). Optical coherence tomography showed hyperreflective inner retinal layers and subretinal fluid. Full examination of the fellow eye was unremarkable. The patient started a course of high-dose oral steroids, followed by a slow tapering. After 1 month, BCVA was 20/25 and fundoscopy revealed a complete resolution of the retinal findings. Optical coherence tomography displayed mild inner retinal atrophy and focal extrafoveal ellipsoid zone disruption with complete reabsorption of subretinal fluid.

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Referências

Purtscher O. Noch unbekannte befunde nach schadel-trauma. Ber Dtsch Ophthalmol Ges. 1910;36:294-301.

Purtscher O. Angiopathia retinae traumatica. Lymphorrhagien des Augengrundes. Graefes Arch Oph-thalmol. 1912;82:347-371.

Agrawal A, McKibbin MA. Purtscher’s and Purtscher-like retinopathies: a review. Surv Ophthalmol. 2006;51:129-36. doi: 10.1016/j.survophthal.2005.12.003.

Miguel AI, Henriques F, Azevedo LF, Loureiro AJ, Maberley DA. Systematic review of Purtscher’s and Purtscher-like retinopathies. Eye. 2013;27:1-13. doi: 10.1038/eye.2012.222.

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Publicado

2021-03-31

Como Citar

Pinto, C., Gouveia, P., & Calvão Santos, G. (2021). Uma Apresentação típica de Retinopatia de Purtscher. Revista Sociedade Portuguesa De Oftalmologia, 45(1), 59–60. Obtido de https://revistas.rcaap.pt/index.php/oftalmologia/article/view/23940

Edição

Secção

Comunicações curtas e imagens em Oftalmologia