Retinal Hemorrhages Research Articles

Characteristics and associations of ocular and non-ocular manifestations of shaken baby syndrome.

Shaken baby syndrome (SBS), a subset of abusive head trauma, results from non-accidental, violent head shaking. Most survivors suffer permanent neurological sequelae. Accurate diagnosis is imperative and remains challenging. The purpose of this study is to describe ocular injuries and associated neurotrauma in suspected SBS. We retrospectively surveyed the National Trauma Data Bank 2008-2014 for patients ≤3years old admitted for suspected SBS. Statistical analysis was performed with SPSS software. Significance was set at p < 0.05. Three hundred forty-seven (13.9%) of 2495 patients who were ≤ 3years old were admitted with abusive head trauma and ocular injuries which resulted from suspected SBS. Most were < 1year old (87.9%) and male (54.2%). Common eye injuries were retinal hemorrhages (30.5%), eye/adnexa contusion (14.7%), and retinal edema (10.7%). Common neurotrauma were subdural (75.5%), subarachnoid (23.9%), and intracerebral hemorrhage (ICH) (10.4%). Mean (SD) Injury Severity Score was severe, 20.2 (8.2), and Glasgow Coma Score was moderate, 9.2 (12.8). The mortality rate was 16.7%. Retinal hemorrhages were not significantly associated with one type of neurotrauma over others. Ocular/adnexa contusion (OR 4.06; p < 0.001) and commotio retinae/Berlin's edema (OR 5.27; p < 0.001) had the greatest association with ICH than other neurotrauma. Optic neuropathy (OR 21.33; p < 0.001) and ICH (OR 3.34; p < 0.001) had the highest associated with mortality. Our study supports previous studies showing that retinal and subdural hemorrhages were the most common ocular injury and neurotrauma in SBS, respectively. However, we did not find a significant propensity for their concurrence. Commotio retinae/Berlin's edema was significantly associated with both intracerebral and subdural hemorrhages.

Ophthalmic artery ischemia in hemophagocytic lymphohistiocytosis: A case report and review of current literature

Introduction: This case report describes the ocular manifestations of hemophagocytic lymphohistiocytosis in a 35-year-old male with suspected Adult-onset Still’s Disease. Documented ocular presentations of hemophagocytic lymphohistiocytosis are variable, and the pathophysiology remains unclear. A complete review of the current literature suggests that posterior segment findings, including retinal and vitreous hemorrhage, are most common. Case Report: Here we describe the first published case of bilateral combined choroidal and retinal ischemia in a patient with ocular hemophagocytic lymphohistiocytosis. This is suggestive of complete ophthalmic artery occlusion driving proliferative retinopathy. Mechanistic hypotheses include anemia, thrombocytopenia, coagulopathy, and histiocytic infiltration. Conclusion: In this case, pre-retinal hemorrhage, retinal hemorrhage, and vitreous hemorrhage were treated with panretinal photocoagulation, pars plana vitrectomy, and bevacizumab at different stages in each eye. Unusually for ocular hemophagocytic lymphohistiocytosis, the patient developed a unilateral tractional retinal detachment, later thought to be due to early administration bevacizumab prior to vitrectomy in the left eye. Final visual acuity in this patient remains poor, and worse in the left eye. We therefore suggest early vitrectomy to maintain adequate views of the fundus before bevacizumab or panretinal photocoagulation in this patient cohort.

Causes of Vision Loss Associated with Dengue Fever in Bihar, India - A Case Series.

The incidence and geographic distribution of dengue has increased dramatically in recent years across various parts of the world. Previously, ocular findings in dengue fever were considered rare. We report a spectrum of ocular manifestations presenting with vision loss in the last dengue epidemic in an eastern state of India. This is a retrospective interventional case series of patients with vision loss who were diagnosed with dengue eye disease in the 2022 epidemic. Systemic and ophthalmic examinations were completed on all patients and were analyzed. Fifteen patients had presented with vision loss. The mean age was 41.7 ± 10.8 years, and patients were mostly males. Three patients presented with panophthalmitis and orbital cellulitis. Eight patients were diagnosed with optic neuropathy. Four patients had macular involvement: macular chorioretinitis, macular subhyaloid hemorrhage, and macular hemorrhages in two patients. All patients with optic neuropathy gave a history of mild fever and had remained undiagnosed. The rest had been diagnosed with the more severe dengue hemorrhagic fever. Vision recovered partially or fully in patients with optic neuropathy and macular disease. No eye could be salvaged in any panophthalmitis patients. Thrombocytopenia (platelet count <100 × 109 per liter of blood) was significantly associated with ocular hemorrhage and panophthalmitis, but thrombocytopenia was not significantly seen in optic neuropathy. We conclude that optic neuropathy may be an underreported cause of vision loss in dengue fever. An eye examination is advocated in all patients with dengue eye disease.

Association between biological aging and diabetic retinopathy

The impact of aging on diabetic retinopathy (DR) remains underestimated. The current study aimed to investigate the association between biological aging and DR, in contrast to chronological age (CA). Using the National Health and Nutrition Survey data from 2005 to 2008. Biological aging was evaluated through the biological age (BA) and phenotypic age (PA), which were calculated from clinical markers. DR was identified in participants with diabetes mellitus (DM) when they exhibited one or more retinal microaneurysms or retinal blot hemorrhages under retinal imaging, with or without the presence of more severe lesions. Survey-weighted multivariable logistic regression was performed, and the regression model was further fitted using restricted cubic splines. The discriminatory capability and clinical utility of the model were evaluated using receiver operating characteristic (ROC) curves and decision curve analysis (DCA). Based on weighted analyses, of the 3100 participants included in this study, of which 162 had DR. In the adjusted model, BA (odds ratio [OR] = 1.12, 95% CI, 1.06–1.18) and PA (OR = 1.11, 95% CI, 1.07–1.14) were associated with DR, while CA was not significantly (OR = 1.01, 95% CI, 0.99–1.03). Narrowing the analysis to DM participants and adjusting for factors like insulin showed similar results. ROC and DCA analyses indicate that BA/PA predicted DR better than CA and offer greater clinical utility. The positive association between BA/PA and DR was consistent across subgroups despite potential interactions. Biological aging heightens DR risk, with BA/PA showing a stronger association than CA. Our findings underscored the importance of timely anti-aging interventions for preventing DR.

The eye in forensic practice: In the dead.

Post-mortem examination of the eye provides valuable forensic information yet is often overlooked. This brief review focuses on determining the cause/manner of death and post-mortem interval. External eye findings like corneal haziness and tache noire, combined with post-mortem changes in the iris, lens, retina and vitreous humour, can help estimate time since death. Ocular biometrics (iris/retinal scans) may facilitate identification. Age-related ocular changes can provide insights. The eye offers clues into personality (corneal tattooing, trichotillomania) and cause of death (petechiae in strangulation, retinal haemorrhages in abusive head trauma). Ocular trauma and underlying eye disease may be evident. Toxicology of vitreous humour can detect drugs/poisons. As a window into systemic disease and age-related changes, the eye aids pathology interpretations and, accordingly, post-mortem examinations have value. Ocular findings should not be overlooked in forensic examinations as they provide distinct information in determining cause/manner of death and post-mortem interval.

Unusual Retinal Hemorrhages in a Highly Myopic Patient

Unusual Retinal Hemorrhages in a Highly Myopic Patient

Randomized Trial Comparing Micro-Serrated versus Conventional Internal Limiting Membrane Forceps for Internal Limiting Membrane Peeling

Purpose: To evaluate macular findings and surgeon evaluation regarding the use of micro-serrated (SharkskinTM, Alcon, Forth Worth, TX) internal limiting membrane (ILM) forceps compared to conventional (Grieshaber® (Alcon)) ILM forceps for peeling of the ILM. Methods: Patients were prospectively assigned in a 1:1 randomized fashion to undergo ILM peeling using the micro-serrated forceps or conventional forceps. Rates of retinal hemorrhages, deep retinal grasps, ILM regrasping, time to ILM removal, and surgeon questionnaire comparing the use of micro-serrated and conventional ILM forceps. Results: A total of 90 eyes of 90 patients were included in the study. The mean number of deep retinal grasps was higher in the conventional forceps group (1.51 ± 1.70 versus 0.33 ± 0.56, respectively [p &lt; 0.0001]). The mean number of failed ILM grasps was higher with conventional forceps (6.62 ± 3.51 versus 5.18 ± 2.06 [p = 0.019]). Micro-serrated forceps provided more comfortability (lower number) in initiating the ILM flap (2.16 ± 0.85 versus 1.56 ± 0.76, [p &lt; 0.001]), comfortability in regrasping the ILM flap was (2.51 ± 1.01 versus 1.98 ± 0.89, p = 0.01), and comfortability in completing the ILM flap (2.42 ± 1.03 versus 1.84 ± 1.02, p = 0.01). Conclusion: Surgeons utilizing the micro-serrated forceps experienced fewer deep retina grasps and fewer failed ILM grasps using compared to conventional ILM forceps. The micro-serrated forceps was also a more favorable experience subjectively amongst the surgeons.

Fatal child abuse detected by systematic post-mortem fundus photograph in sudden death in infancy.

In living children, the use of a wide field fundus camera such as RetCam is the gold standard practice to document retinal haemorrhages in suspected cases of abusive head trauma (AHT). In case of sudden unexpected death in infancy (SUDI), child abuse must be considered as a possible cause of death and an eye examination is required. However, no example of post-mortem fundus photograph (PMFP) of retinal haemorrhages related to AHT is yet available for clinicians.We report a SUDI case, with no external traumatic lesions or limb fractures, for which prompt PMFP showed retinal haemorrhages typical of AHT: child abuse was subsequently confirmed by the forensic investigation. We discuss why PMFP is a relevant screening test to detect retinal haemorrhages in the case of SUDI and why the use of the RetCam should be further investigated.

OUTCOMES OF INFECTIOUS PANUVEITIS ASSOCIATED WITH SIMULTANEOUS MULTI-POSITIVE OCULAR FLUID POLYMERASE CHAIN REACTION.

To evaluate features of infectious panuveitis associated with multiple pathogens detected by ocular fluid sampling. Single-center, retrospective, consecutive case series of patients with aqueous/vitreous polymerase chain reaction testing with >1 positive result in a single sample from 2001 to 2021. Of 1,588 polymerase chain reaction samples, 28 (1.76%) were positive for two pathogens. Most common pathogens were cytomegalovirus (n = 16, 57.1%) and Epstein-Barr virus (n = 13, 46.4%), followed by varicella zoster virus (n = 8, 28.6%), Toxoplasma gondii (n = 6, 21.4%), herpes simplex virus 2 (n = 6, 21.4%), herpes simplex virus 1 (n = 6, 21.4%), and Toxocara (n = 1, 3.6%). Mean initial and final visual acuity (logarithm of the minimum angle of resolution) were 1.3 ± 0.9 (Snellen ∼20/400) and 1.3 ± 1.1 (Snellen ∼20/400), respectively. Cytomegalovirus-positive eyes (n = 16, 61.5%) had a mean final visual acuity of 0.94 ± 1.1 (Snellen ∼20/175), whereas cytomegalovirus-negative eyes (n = 10, 38%) had a final visual acuity of 1.82 ± 1.0 (Snellen ∼20/1,320) ( P < 0.05). Main clinical features included intraocular inflammation (100%), retinal whitening (84.6%), immunosuppression (65.4%), retinal hemorrhage (38.5%), and retinal detachment (34.6%). Cytomegalovirus or Epstein-Barr virus were common unique pathogens identified in multi-PCR-positive samples. Most patients with co-infection were immunosuppressed with a high rate of retinal detachment and poor final visual acuity. Cytomegalovirus-positive eyes had better visual outcomes compared with cytomegalovirus-negative eyes.

Association between the arm-to-choroidal circulation time and clinical profile in patients with polypoidal choroidal vasculopathy.

To investigate the association between the arm-to-choroidal circulation time (ACT) on indocyanine green angiography (IA) and clinical profile in patients with polypoidal choroidal vasculopathy (PCV). Single-center retrospective study. We included 38 eyes of 38 patients with PCV diagnosed using multimodal imaging and did not undergo previous treatment. All patients were treated with monthly aflibercept injections for 3 months and treat-and-extend regimens for the subsequent 12 months. Posterior vortex vein ACT was assessed on the first visit using Heidelberg IA. The patients were divided into two groups: ACT ≥20 s (L group; eight eyes) and ACT <20 s (S group; 30 eyes). The clinical profiles before and after treatment were analyzed to assess associations with ACT. The mean ACT was 16.39±3.3 s (L group: 21.25±1.49 s, women:men=2:6, mean age: 77.3±6.5 years; S group: 15.10±2.17 s, women:men=7:23, mean age: 75.5±6.9 years). No significant difference was observed in the mean subfoveal choroidal thickness between the L and the S groups (176±75 μm vs. 230±79 μm, P=0.10). However, there were significant differences between the L and S groups in retinal fluid accumulation and hemorrhage recurrence (eight/eight eyes, 100% vs. 13/30 eyes, 43%, P<0.001), mean aflibercept injections (8.8±1.6 vs. 7.0±1.6, P<0.01) during the 12-month period, and the number of polypoidal lesions (1.8±0.7 vs. 1.3±0.5, P<0.05). Patients with PCV and ACT >20 s are more likely to experience exudative change recurrence in the retina during treatment because they have more polypoidal lesions.

Comparative Analysis of Early Diabetic Retinopathy Detection: Enhanced Minimal CNN vs VGG Architecture on CLAHE- Preprocessed Retinal Images

Ocular impairment is one of the prominent problems affecting middle-aged individuals due to uncontrolled blood sugar levels, commonly known as Diabetic Retinopathy (DR). The small abnormalities in the retinal capillaries, called microaneurysms and intra retinal bleeding, are the initial symptoms of Diabetic Retinopathy. Clinically recognizing diabetic retinal disease is a time-consuming and difficult process due to limitations in resources and experienced doctors. Early detection is crucial in avoiding the progression of Diabetic Retinopathy, highlighting the importance of an automated DR detection method to identify symptoms in its early stages. In this paper, researchers developed an unfamiliar framework known as Enhanced Minimal Convolutional Neural Network (EMCNN) to classify Mild-DR and No-DR ophthalmic photos using a binary classification process. The proposed new model EMCNN is compared with the migration learning method using the existing framework VGG16 and VGG19 in terms of precision and effectiveness. Before being sent across the network, the fundus pictures underwent preprocessing using the Contrast Limited Adaptive Histogram Equalization (CLAHE) tactic. EMCNN is an experimental model that enjoys a minimum number of layers and batch normalization to minimize the training effort. The EMCNN model achieved 94.89% accuracy using 3100 image dataset which is a remarkable improvement when compared with VGG architectures since the VGG architecture is trained with millions of images.   

Beyond the AJR: Deep Learning Shows Promise in the Detection of Retinal Hemorrhage on Pediatric Head CT.

Beyond the AJR: Deep Learning Shows Promise in the Detection of Retinal Hemorrhage on Pediatric Head CT.

Retinal Hemorrhages in a Newborn with Prenatal Cocaine Exposure

A term male newborn small for gestational age and with microcephaly was born from uncomplicated vaginal delivery. Pregnancy was not followed up until 32 weeks. Maternal serologies and vaginal/rectal swabs were negative. Routine ophthalmoscopy revealed hemovitreous in the right eye and massive retinal hemorrhages (RH) in the left eye; subsequent RetCam II examination with fluorescein angiography revealed bilateral RH, involving the fovea in the left eye. Retinal vascularization was normal in both eyes, without signs of ischemic injury or pathological angiogenesis. Complete blood count, coagulation, and thrombophilic studies were normal; a toxicology screen, performed on a hair sample from both mother and infant, was positive for cocaine. With its significant vasoconstrictive effects, cocaine may induce ischemic-hypoxic damage in the developing retinal vascular system of the fetus, leading to extensive RH. Although cocaine-related RH is indistinguishable from other birth-related RH, the formers persist for longer periods, warranting prolonged follow-up and long-term evaluation of visual function.

Recovery of Vision in Open Globe Injury Patients with Initial No Light Perception Vision

Objective or PurposeTo identify clinical characteristics of injured eyes associated with visual recovery in patients with open globe injuries (OGI) and presenting with no light perception (NLP) vision. DesignRetrospective chart review. Subjects, Participants, and/or ControlsAll patients presenting to Massachusetts Eye and Ear with OGI and NLP vision from January 1999 to March 2022. Methods, Intervention, or TestingManual data extraction to collect patient demographic characteristics, pre-operative, intraoperative, and post-operative characteristics of OGI injury, laceration versus rupture, history of intraocular surgery, time from injury to repair, timing of vitrectomy, lensectomy, choroidal drainage, and silicone oil placement, visual acuity (VA) at last follow-up, and subsequent B-scan ultrasound findings of retinal detachment, choroidal hemorrhage, vitreous hemorrhage, and disorganized intraocular contents. Patients with more than one week of follow-up and a documented VA at most recent follow-up were included. Exclusion criteria included age less than 10 years. Multivariable regression was performed. Main OutcomesVA recovery defined as light perception or better in patients with OGI and initial NLP vision. Results147 eyes with NLP vision after OGI were included. 25 (17%) eyes regained vision at last follow-up. The majority of patients recovered light perception vision (n=15, 60%) followed by 20/500 or better (n=5, 20%), hand motion (n=3, 12%), and count fingers (n=2, 8%). Most injuries were zone III (n=102, 69%) and presented with rupture (n=127, 86%). The mean time from OGI to surgical repair was 0.85 ± 1.7 days. B-scan was obtained in 104 (71%) cases. Pars plana vitrectomy was performed in 9 eyes (6%) with NLP at time of vitrectomy. Disorganized intraocular contents on B-scan (OR=0.170, 95%CI: 0.042-0.681, P=0.012) was the only clinical variable significantly associated with visual recovery, corresponding to a lack of visual improvement. ConclusionRecovery of vision in OGI with NLP vision at presentation cannot be predicted based on presenting clinical features. B-scan findings of disorganized intraocular contents after initial OGI repair was the only factor negatively associated with vision recovery in this patient population. Therefore, all eyes presenting with an OGI and NLP vision should undergo primary repair in hopes of subsequent visual recovery.

Paradoxical clinical presentation in ocular trauma following road traffic accident – A case report

Ocular trauma following road traffic accident is one of the main causes of preventable monocular blindness in young adult men and a significant contributor to severe vision impairment in people of all ages. Though helmet protects the riders from severe brain injury and also protects the face, still ocular injuries are possible even wearing a helmet. We are presenting here a case of ocular trauma following road traffic accident in a 34-year-old male wearing helmet, in whom there were anterior segment injuries in one eye without any defect in vision, whereas without any external ocular injury, the other eye had sever retinal edema, hemorrhage, and vitreous hemorrhage, grossly affecting the vison in that eye. Any patient even with mid-facial injuries should be evaluated for suspected ocular impairment and rule out the potential need for early intervention to prevent blindness.

CENTRAL BOUQUET HEMORRHAGE: Clinical and Multimodal Imaging Features.

To describe the clinical characteristics, multimodal imaging features, and anatomic basis of a distinctive pattern of deep retinal hemorrhages located in the central fovea, a presentation referred to as "central bouquet hemorrhage." Retrospective, observational, multicenter case series of eyes with central bouquet hemorrhage. Multimodal imaging features were reviewed and analyzed. Ten eyes from 10 patients (4 women and 6 men), with a mean age of 55.6 ± 21.7 years (range 25-84 years) were included. Underlying etiologies were neovascular age-related macular degeneration (40%), lacquer cracks in pathological myopia (30%), macular telangiectasia Type 2 (10%), proliferative diabetic retinopathy (10%), and ocular trauma associated with angioid streaks (10%). On ophthalmoscopy, all eyes with central bouquet hemorrhage displayed a deep retinal hemorrhage with round margins in the central fovea and associated with petaloid hemorrhages radiating in the surrounding Henle fiber layer. Cross-sectional optical coherence tomography showed a well-delineated round hyperreflective lesion involving the central foveal Henle fiber layer/outer nuclear layer in all cases. Accompanying hyperreflective hemorrhages tracking along the obliquely oriented Henle fiber layer were present in all eyes. Resolution occurred in all patients, either spontaneously (30%) or after treatment with intravitreal anti-vascular endothelial growth factor injections (70%), and was associated with partial visual acuity improvement (from 20/113 to 20/36). "Central bouquet hemorrhage" is a novel descriptive term describing a characteristic round pattern of intraretinal blood in the fovea associated with Henle fiber layer hemorrhage and encountered in a spectrum of macular disease.

Neonatal Macular Hemorrhage in a Term Healthy Infant: 18-Year Follow-up.

Unobstructed binocular vision is required during the critical period of vision development to obtain optimal visual acuity in each eye and binocular stereopsis. In this article, we report 18-year follow-up of a full-term, otherwise healthy infant noted to have dense premacular hemorrhage occluding the visual axis in the left eye on retinal imaging performed 48 hours after birth. Serial examinations by the retina service were performed weekly for 10 weeks as the hemorrhage resolved spontaneously. Shortly thereafter, visual acuity revealed fixation was present, but the mother noted intermittent left eye esodeviation. At 90 days of life, the infant was seen by pediatric ophthalmology and started on 1 to 2 hours patching of the right eye daily for the esotropia, which was maintained through 24 months. At 18 years of age, the patient had orthophoria alignment, no spectacle correction, vision of 20/20 in the right eye and 20/25 in the left eye, and normal binocularity and stereopsis. Intermittent esodeviation on the left eye was observed when the patient was fatigued. Early identification of a visual axis occlusion led to prompt referral for the esotropia and initiation of patching therapy. This patient ultimately achieved a very favorable visual functional outcome that may not have been possible without early detection and management. This case report describes the longest-term published follow-up of a neonatal macular hemorrhage. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

Hyperviscosity Syndrome Revealed by White-Centered Retinal Hemorrhages (Roth Spot)

White-centered retinal hemorrhages, also known as Roth spots, have long been considered pathognomonic of infective endocarditis but can be associated with several pathologies. They can be a presentation of a blood hyperviscosity syndrome in the context of multiple myeloma, light chain gammopathy, or cryoglobulinemia through a mechanism of retinal venous stasis, potentially progressing to vein occlusion. We present the case of a 55-year-old woman with no significant medical history who presented a gradual bilateral decline in visual acuity. Fundoscopic examination revealed multiple white-centered hemorrhages, and further investigation promptly linked them to a blood hyperviscosity syndrome.

Comparative Analysis of Early Diabetic Retinopathy Detection: Enhanced Minimal CNN Vs VGG Architecture on CLAHE- Preprocessed Retinal Images

Ocular impairment is one of the prominent problems affecting middle-aged individuals due to uncontrolled blood sugar levels, commonly known as Diabetic Retinopathy (DR). The small abnormalities in the retinal capillaries, called microaneurysms and intra retinal bleeding, are the initial symptoms of Diabetic Retinopathy. Clinically recognizing diabetic retinal disease is a time-consuming and difficult process due to limitations in resources and experienced doctors. Early detection is crucial in avoiding the progression of Diabetic Retinopathy, highlighting the importance of an automated DR detection method to identify symptoms in its early stages. In this paper, researchers developed an unfamiliar framework known as Enhanced Minimal Convolutional Neural Network (EMCNN) to classify Mild-DR and No-DR ophthalmic photos using a binary classification process. The proposed new model EMCNN is compared with the migration learning method using the existing framework VGG16 and VGG19 in terms of precision and effectiveness. Before being sent across the network, the fundus pictures underwent preprocessing using the Contrast Limited Adaptive Histogram Equalization (CLAHE) tactic. EMCNN is an experimental model that enjoys a minimum number of layers and batch normalization to minimize the training effort. The EMCNN model achieved 94.89% accuracy using 3100 image dataset which is a remarkable improvement when compared with VGG architectures since the VGG architecture is trained with millions of images

Internal limiting membrane separation and posterior vitreous hyperreflective dots: novel OCT findings in Purtscher-like retinopathy

BackgroundPurtscher or Purtscher-like retinopathy is diagnosed by retinal hemorrhages and areas of retinal whitening on fundus examination, as well as a reduction in visual acuity due to microvascular occlusion of the precapillary retinal arterioles. We describe novel optical coherence tomography (OCT) findings of internal limiting membrane (ILM) separation and posterior hyperreflective dots in a case of Purtscher-like retinopathy in this report.MethodsA 33-year-old man with acute pancreatitis and alcohol-induced liver disease presented to the retina department complaining of four days of painless vision loss in both eyes. Both eyes’ anterior segment examination and intraocular pressure were normal. Dilated fundus examination of both eyes revealed confluent areas of retinal whitening, hemorrhages, and cotton-wool spots over the posterior pole, indicating Purtscher-like retinopathy. OCT scans through the macula revealed dense inner retinal reflectivity, thickening, and loss of retinal layer stratification, as well as outer retinal layer shadowing and islands of ILM separation, posterior vitreous hyperreflective dots, and minimal subfoveal fluid, all of which corresponded to areas of retinal whitening on fundus photographs. The patient was given a brief course of systemic steroids.ResultsOn the tenth day after the presentation, visual acuity in the right eye had improved to 6/18 and finger counting at 1 m in the left eye. The retinal findings had faded. The retina had reverted to its normal thickness on the OCT scans, with minimal hyperreflectivity remaining. The ILM separation and posterior vitreous hyperreflective dots were no longer present.ConclusionFollowing Purtscher or Purtscher-like retinopathy, we believe inflammation could play a major role in the development of these two novel OCT findings. This case offers an additional perspective on the underlying mechanisms responsible for the retinal manifestations observed in Purtscher or Purtscher-like retinopathy.