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Updated: Jan 3, 2026
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography
Bing Li1, Donghui Li1, Youxin Chen2
1Department of Ophthalmology, Peking Union Medical College Hospital, Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People's Republic of China.
Background:
To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and OCT angiography (OCT-A) findings before and after treatment.
Case Presentation:
A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination revealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right eye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT presented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute middle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and choriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed resolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern turned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the choriocapillaris.
Conclusion:
This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the choriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.
