Purtscher's retinopathy

Purtscher's retinopathy (a.k.a. angiopathia retinae traumatica) is a traumatic angiopathy, most commonly caused by head and chest trauma. The most-prevalent bilateral retinal signs include white ischemic infarcts (cotton-wool spots or Purtscher-flecken) and hemorrhages (dot and blot, pre-retinal, or flame). The prognosis for patients with decreased vision is unpredictable.

A 19-year-old man came to the Louis Stokes Cleveland Veterans Administration Optometry Clinic for a consultation to rule out ocular anomalies associated with a motor vehicle accident. The patient was diagnosed with Purtscher's retinopathy in the right eye due to cotton-wool spots observed during fundus examination, an air embolism discovered on chest X-ray, and a history of head/chest trauma. All signs and symptoms had resolved by 1-month follow-up examination. The patient's visual acuity resolved to 20/30 in the right eye.

Purtscher's retinopathy is a traumatic angiopathy with an uncertain pathophysiology. A case report and review are presented, and the role of optometry in its management is discussed.