Optical Coherence Tomography Angiography Findings in Post-Traumatic Purtscher Retinopathy: A Case Report

Area of Science:

• Ophthalmology
• Vascular Biology

Background:

• Purtscher retinopathy (PR) is a rare, vision-threatening condition typically following trauma.
• Characterized by retinal whitening and hemorrhages, PR is linked to microvascular occlusion in retinal arterioles.
• Optical coherence tomography angiography (OCT-A) aids in understanding PR's microvascular alterations and ischemic pathogenesis.

Purpose of the Study:

• To report a case of Purtscher retinopathy with retinal and choroidal circulatory changes.
• To discuss the prognostic significance of these ischemic alterations.

Main Methods:

• Case report of a 63-year-old male with head/neck trauma and vision loss.
• Ophthalmic examination including Optical Coherence Tomography (OCT) and OCT angiography (OCT-A).
• High-dose systemic corticosteroid therapy initiated.

Main Results:

• OCT-A revealed extensive capillary non-perfusion in retinal plexuses and suspected choriocapillaris ischemia.
• Despite treatment, persistent retinal and choroidal perfusion deficits were noted at 3-month follow-up.
• Final visual acuity was poor due to retinal, choroidal, and optic nerve ischemic atrophy.

Conclusions:

• Purtscher retinopathy can affect both retinal and choroidal circulation.
• OCT-A is effective for detecting and monitoring microvascular changes in PR.
• Combined retinal and choroidal ischemia in PR is associated with poor visual prognosis.