A Case of Purtscher Retinopathy Associated with Stent-Assisted Coil Embolization of a Middle Cerebral Artery Aneurysm

Abstract

This article reports a case of Purtscher retinopathy following therapeutic coil embolization of a middle cerebral artery (MCA) aneurysm. METHODS. Case report. A 53-year-old woman with a history of stent-assisted coil embolization in her left MCA unruptured aneurysm presented with a visual disturbance about 3 hours after the procedure. Her left eye vision was 20/40. Fundus examination of the left eye showed an intraretinal hemorrhage and multiple whitish retinal lesions. The spectral-domain optical coherence tomography (OCT) examination showed focal thickness around the whitish lesions and a hemorrhage site. Three weeks later, the retinal whitish lesions decreased but new multiple intraretinal hemorrhages were found near the previous whitish lesions. Fluorescein angiography revealed the obstruction of an arteriole at the posterior pole. After 5 weeks, all lesions in the fundus photography and OCT were almost gone and her left visual acuity was 20/20. A thorough understanding of clinical findings and mechanism of this disorder, including the possibility of direct emboli during coil embolization rather than secondary emboli from the postoperative coil-thrombus complex formed in the aneurysm after the procedure, is therefore necessary to prevent unwanted ocular complications after coil embolization.