Purtscher-like Retinopathy in a Patient with Acute Pancreatitis: A Case Report and Literature Review.

Abstract

Purtscher-like retinopathy is a rare chorioretinopathy associated with a non-traumatic inciting event including acute pancreatitis, renal failure, long-bone injury, chest compression, connective tissue diseases and hematologic disorders. We present the case of a 33-year-old woman with abdominal pain and visual changes that was diagnosed with acute pancreatitis. Fundoscopic examination revealed bilateral diffuse flame hemorrhages and retinal whitening (Purtscher flecken), which were diagnostic of Purtscher-like retinopathy secondary to acute pancreatitis. The patient improved without intravenous or intravitreal corticosteroid administration. Follow up at 5 and 8 months revealed improved vision, complete resolution of the retinal pathology with residual inner retinal thickening on ocular coherence tomography (OCT), consistent with sustained retinal damage. Given that Purtscher-like retinopathy is associated with higher morbidity and mortality rates in patients with acute pancreatitis, high suspicion of this pathology and a thorough clinical assessment are imperative. Since half of the patients suffer life-long visual changes, further research is required for the development of efficacious treatment options.