Abstract
IntroductionPurtscher's retinopathy is a rare condition that is noted in cases related to various types of trauma. The characteristic finding in the fundus is the presence of multiple Purtscher flecken. Purtscher-like retinopathy has a similar presentation in the fundus, but without an association with trauma.Case presentationA 43-year old Malay man presented with a sudden onset of central foggy vision in the left eye after holding his breath for two minutes while catching a falling object. It was not associated with floaters, flashes of light, or head trauma. His vision in the right eye was 6/6, and in his left eye it was finger counting. He had bilateral temporal sub-conjunctival hemorrhages. An examination of his left fundus revealed multiple white cotton wool spots and dot-blot retinal hemorrhages with diffuse retinal edema at the posterior pole. His right fundus was noted to have only mild temporal peri-papillary edema associated with a few dot-blot hemorrhages. Fundus fluorescein angiography showed good arterial perfusion and no evidence of leaking or neo-vascularization. A diagnosis of Purtscher-like retinopathy was made, and the patient was treated with indomethacin tablets for six weeks. At his six-week follow-up examination, his left eye visual acuity had improved to 6/12. His bilateral sub-conjunctival hemorrhage had resolved. His left fundus showed residual multiple cotton wool spots and reduced retinal edema.ConclusionsTreatment with non-steroidal anti-inflammatory drugs seems to be effective in reducing edema in patients with Purtscher-like retinopathy.
Highlights
Purtscher’s retinopathy is a rare condition that is noted in cases related to various types of trauma
Treatment with non-steroidal anti-inflammatory drugs seems to be effective in reducing edema in patients with Purtscher-like retinopathy
We report the case of a patient with Purtscherlike retinopathy that occurred after the Valsalva maneuver effect
Summary
Purtscher’s retinopathy is a rare condition and is noted in cases associated with various types of trauma, including head trauma, seatbelt and airbag pressure, malar bone fracture, crush injury, and chest trauma [1,2,3,4]. Case presentation A 43-year old Malay man presented to our hospital with sudden-onset blurring of the vision, which he described as central foggy vision that occurred after he caught a His right eye vision was 6/6, and his left eye acuity was finger counting, which improved to 6/90 using the pinhole test. He had profound temporal sub-conjunctival hemorrhages bilaterally (Figure 1) but no other significant abnormalities in the anterior segment. A diagnosis of Purtscher-like retinopathy following a Valsalva maneuver was made He was treated with indomethacin tablets 25 mg daily for six weeks. At his sixweek follow-up examination, the visual acuity of his left eye had improved to 6/12 His sub-conjunctival hemorrhages in both eyes and his right eye temporal peripapillary edema had resolved. The left fundus appeared to have residual macular edema and resolving cotton wool spots (Figure 3)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
