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Pathogenesis of Purtscher's retinopathy. An experimental study
W Behrens-Baumann1, G Scheurer, H Schroer
1Augenklinik, Universität Göttingen, Federal Republic of Germany.
Abstract:
Laboratory and clinical observations have implicated microparticles in the pathogenesis of Purtscher's retinopathy, which leads to the occlusion of small arterioles. These microparticles may be caused by aggregated leukocyte platelets or fibrin clots. The phenomenon of intravascular coagulation is well known following trauma or acute pancreatitis. Purtscher's retinopathy is linked with both diseases. To support this presumed pathogenesis of Purtscher's retinopathy, fibrin clots ranging in size from 0.15 to 1.0 mm were injected into the ophthalmic artery of the pig. They resulted in superficial and deep retinal infarctions. In addition, flame-shaped and spotted hemorrhages occurred. These retinal changes are characteristic of Purtscher's retinopathy.
Insights
Microparticles, potentially from leukocyte platelets or fibrin clots, are implicated in Purtscher's retinopathy. Injecting fibrin clots into pig ophthalmic arteries mimicked the retinal changes seen in this condition.
Area of Science:
- Ophthalmology
- Pathophysiology
- Vascular Biology
Background:
- Purtscher's retinopathy involves occlusion of small retinal arterioles.
- Microparticles, possibly from aggregated leukocyte platelets or fibrin clots, are suspected contributors.
- Intravascular coagulation is associated with trauma and acute pancreatitis, conditions linked to Purtscher's retinopathy.
Purpose of the Study:
- To investigate the role of fibrin clots in the pathogenesis of Purtscher's retinopathy.
- To experimentally induce retinal changes characteristic of Purtscher's retinopathy.
Main Methods:
- Fibrin clots (0.15–1.0 mm) were injected into the ophthalmic artery of pigs.
- Retinal changes were observed and analyzed post-injection.
Main Results:
- Superficial and deep retinal infarctions were observed.
- Flame-shaped and spotted hemorrhages occurred in the retina.
- Induced changes were characteristic of Purtscher's retinopathy.
Conclusions:
- Fibrin clots can experimentally induce retinal changes consistent with Purtscher's retinopathy.
- This supports the hypothesis that microparticle-induced intravascular coagulation contributes to the disease's pathogenesis.