Retinopathy associated with acute pancreatitis

Area of Science:

• Ophthalmology
• Internal Medicine
• Vascular Biology

Background:

• Acute pancreatitis can lead to systemic complications.
• Ocular manifestations of pancreatitis are rare but can be severe.
• Understanding the retinal changes in pancreatitis is crucial for diagnosis and management.

Observation:

• Two young patients with acute pancreatitis presented with sudden, severe vision loss.
• Funduscopic examination revealed retinal edema, cotton-wool patches, and hemorrhages, primarily in the posterior pole.
• Fluorescein angiography demonstrated occlusion of retinal vessels in the affected areas.

Findings:

• Over a five-year follow-up, both patients experienced significant visual acuity improvement.
• Repeated angiography confirmed reperfusion of previously occluded retinal vessels.
• Resolution of cotton-wool patches led to retinal thinning and internal limiting membrane irregularities.
• Visual field testing revealed corresponding scotomas indicating residual retinal damage.

Implications:

• Acute pancreatitis can cause sight-threatening retinopathy.
• Prompt diagnosis and management of pancreatitis may aid in visual recovery.
• Long-term follow-up is necessary to monitor for visual field defects and retinal changes.
• This case series highlights the potential for visual recovery despite initial severe retinal findings.