Optical coherence tomography angiography in unilateral Purtscher retinopathy

Author: Dhouha Gouider (Tunisia)

Co-authors: Rim Bouraoui, Khaled El Matri, Ahmed Selmi, Marwa Masmoudi, Fatma Mghaieth, Laila Matri

Purpose

To describe a case of Purtscher retinopathy in multimodal imaging including swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCT-A).

Setting/Venue

Department B, Hedi Raies Institute.

Methods

A case report of a patient of Purtscher retinopathy

Results

A 31-year-old man, who underwent a motor vehicle accident resulting in head trauma with cerebral hemorrhage was admitted to the intensive care unit for 30 days. He complained of decreased vision of his right eye after leaving intensive care. His best-corrected visual acuity was positive light perceptions and 10/10 in the right eye and the left eye respectively. Biomicroscopic examination of the anterior segment of eyes was unremarkable, fundus examination revealed retinopathy with multiple cotton wool spots and flame hemorrhages in the posterior pole in intermaculo-papillary. Swept-source OCT showed macular atrophy. Optical coherence tomography angiography revealed extensive non-perfusion in the macular area in both the superficial and the deep capillary plexus of the right eye with normal capillary plexus in the left eye.

Conlusions

Purtscher retinopathy is a rare condition that was first described by Purtscher in 1910 in patients with a history of trauma distant from the eyes with typical findings of cotton wool spots of varying sizes or Purtscher flecken, retinal hemorrhages, and optic disk swelling, are confined to the posterior pole, it is often bilateral but can be unilateral, OCT-A is non-invasive and useful in the detection of retinal vascular damage. The prognosis is generally poor and the visual acuity may remain decreased particularly in the case of foveal photoreceptor atrophy as the case of our patient.

Financial Disclosure

None