Purtscher's retinopathy: epidemiology, clinical features and outcome

Br J Ophthalmol. 2007 Nov;91(11):1456-9. doi: 10.1136/bjo.2007.117408. Epub 2007 Jun 7.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic
  • Acute Disease
  • Adult
  • Aged
  • Animals
  • Epidemiologic Methods
  • Female
  • Humans
  • Ireland / epidemiology
  • Male
  • Middle Aged
  • Pancreatitis / complications
  • Prognosis
  • Remission, Spontaneous
  • Retinal Diseases / epidemiology*
  • Retinal Diseases / etiology
  • Retinal Diseases / physiopathology
  • Retinal Hemorrhage / epidemiology
  • Retinal Hemorrhage / etiology
  • Thoracic Injuries / complications
  • United Kingdom / epidemiology
  • Visual Acuity