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Lee, Park, and Seo: Spontaneously Resolved Purtscher's Retinopathy within 24 Hours: Case Report and OCT Review
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1341-1345.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1341

Spontaneously Resolved Purtscher's Retinopathy within 24 Hours: Case Report and OCT Review

Min Young Lee, MD, Jae Yeong Park, MD, Won Moon Seo, MD

Department of Ophthalmology, Dongkang Medical Center, Ulsan, Korea.

Address reprint requests to Won Moon Seo, MD. Department of Ophthalmology, Dongkang Medical Center, #239 Taehwa-ro, Jung-gu, Ulsan 681-711, Korea. Tel: 82-52-241-1331, Fax: 82-52-241-1146, mdseowm@msn.com

Received 28 November 2011       Accepted 21 July 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of unilateral Purtscher's retinopathy that spontaneously resolved within 24 hours.

Case summary

A 54-year-old man presented with decreased visual acuity in his left eye after a vehicle accident. When the accident occurred, his chest region was compressed by the safety belt. The case was diagnosed with Purtscher's retinopathy based on fundus examination, flourescein angiography (FAG) and optical coherent tomography (OCT). At presentation, the best corrected visual acuity (BCVA) was 0.3 in the affected eye. Tiny Purtscher-flecken and macular edema were observed but there was no sign of retinal hemorrhage. Immediately after the trauma, OCT detected abnormally increased hyperreflectivity in the nerve fiber layer and ganglion cell layer, severe cystoid edema and serous foveal detachment. Without any treatment, BCVA was improved to 1.0 within 12 hours. Recovery of visual acuity was followed by improvement of abnormal hyperreflectivity in the nerve fiber layer, cystoid macular edema and serous foveal detachment.

Conclusions

The authors of the present study report a dramatically resolved unilateral Purtscher's retinopathy after blunt chest trauma.

Keywords: Blunt chest trauma, Optical coherent tomography, Purtscher's retinopathy

Figures and Tables

Figure 1
(A) At presentation, severe cystoid macular edema (asterisk) in fovea and hyper-reflectivity (arrow) in the nerve fiber layer and ganglion cell layer. (B) 7 hours later, cystoid edema much improved. (C) 12 hours later, cystoid edema disappeared and only foveal serous detach is shown. (D) 20 hours later, nearly normal OCT finding but mild edema persists in the outer nuclear layer.
jkos-53-1341-g001
Figure 2
(A) At presentation, loss of foveal reflex and small Purtscher-flecken (black arrow). (B) Red-free image shows retinal nerve fiber damage (yellow arrows).
jkos-53-1341-g002
Figure 3
(A) On fluorescein angiography, minimal fluorescein pooling on the fovea at the arteriovenous phase. (B) Arteriolar stain is shown at the late venous phase.
jkos-53-1341-g003

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