Citation

Agrawal A, McKibbin M. Br. J. Ophthalmol. 2007; 91(11): 1456-1459.

Affiliation

External Eye Diseases & Refractive Surgery, Manchester Royal Eye Hospital, Manchester, UK.

Copyright

(Copyright © 2007, BMJ Publishing Group)

DOI

10.1136/bjo.2007.117408

PMID

17556428

PMCID

PMC2095457

Abstract

AIMS: To study the incidence, systemic associations, presenting features and natural history of Purtscher's retinopathy in the UK and Ireland. METHODS: Cases were collected prospectively by active surveillance through the British Ophthalmological Surveillance Unit. Clinical details were obtained using an incident questionnaire, with follow-up at 1 and 6 months. RESULTS: Clinical details were obtained for 15 cases over 12 months. These were associated with road traffic accidents in 6 cases, chest compression in 6 cases and acute pancreatitis in 3 cases. All cases were symptomatic and presented with loss of visual acuity, visual field or a combination. Bilateral involvement was noted in 9 cases. The acute retinal signs of cotton wool spots, retinal haemorrhage and Purtscher flecken cleared within 1 month in 26% of eyes and within 6 months in all eyes. The most common chronic signs were optic disc pallor and atrophy of the retinal pigment epithelium. Without treatment, 50% of eyes improved by at least 2 Snellen lines at final follow-up and 23% improved by at least 4 Snellen lines. Only 1 of the 24 eyes had a final acuity worse than that recorded at presentation. CONCLUSION: Purtscher's retinopathy is a rare but sight-threatening eye condition, most commonly seen in young or middle-aged men and after trauma. Spontaneous visual recovery of at least 2 Snellen lines is seen in half of the cases.

Language: en