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Purtscher-like retinopathy.
Rita Massa1, Carolina Vale1, Mafalda Macedo1
1Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
Case Reports in Ophthalmological Medicine
|January 30, 2015
Summary
Purtscher-like retinopathy, a rare condition linked to acute pancreatitis, can cause vision loss. This case highlights its association with cholangiocarcinoma and spontaneous visual recovery, emphasizing the need for careful monitoring.
Area of Science:
- Ophthalmology
- Gastroenterology
- Oncology
Background:
- Purtscher-like retinopathy is a severe angiopathy characterized by retinal hemorrhages and ischemia, often linked to acute pancreatitis.
- The underlying pathophysiology is thought to involve complement-mediated leukoembolization.
Purpose of the Study:
- To report a rare case of Purtscher-like retinopathy associated with acute pancreatitis in a patient with Klatskin tumor (hilar cholangiocarcinoma).
- To document the clinical presentation, ophthalmologic findings, and natural course of visual recovery.
Main Methods:
- Case report of a 53-year-old male patient.
- Ophthalmologic evaluation including best corrected visual acuity (BCVA), slit-lamp biomicroscopy, fundoscopy, and optical coherence tomography (OCT).
Main Results:
- The patient presented with decreased visual acuity, scleral icterus, cotton-wool spots, optic disc edema, RPE changes, and intraretinal hemorrhage.
- After 15 months without specific ophthalmologic treatment, BCVA improved to 20/20 in both eyes.
- OCT revealed retinal nerve fiber layer thinning corresponding to previous cotton-wool spots.
Conclusions:
- Purtscher-like retinopathy requires attention in complex clinical settings, even with unclear pathophysiology and uncertain treatment.
- Meticulous follow-up is essential to prevent severe complications associated with this condition.
