A Rare Case of Purtscher-like Retinopathy Secondary to Anti-Synthetase Syndrome: A Case Report and Literature Review

Anti-Synthetase syndrome is a rare and potentially life-threatening subtype of dermatomyositis as part of the spectrum of idiopathic inflammatory myopathy (IIM) that can affect multiple organ systems. Here, we review many of the possible ocular manifestations of this inflammatory myopathy and highlight a case with retinal involvement. A man in his 30's with a history of anti-synthetase syndrome complained of blurred vision of both eyes ongoing for two weeks. A fundoscopic examination revealed numerous cotton wool spots in both eyes without any signs of hemorrhage or Purtscher flecken. Optical coherence tomography showed no evidence of macular edema. A month prior to presentation, the patient was prescribed oral prednisone and IV methylprednisolone in adjunct to mycophenolate mofetil with a recent infusion of rituximab; the drug course was continued. Best corrected visual acuity returned to 20/20 in both eyes with accompanied improvement of cotton wool spots correlating with his course of immunosuppression.