Purtscher-like retinopathy: Ocular findings in a young woman with chronic kidney disease

Abstract

Purpose: To report a case of Purtscher-like retinopathy treated with systemic steroids in a young woman with chronic kidney disease. Observations: An 18-year-old female with a stage 3b chronic kidney disease presented with bilateral, sudden vision loss during an influenza-like syndrome. Best corrected visual acuity (BCVA) was 20/32 bilaterally and fundoscopic examination revealed cotton-wool spots, Purtscher flecken and intraretinal haemorrhages. Flourescein angiography showed areas of retinal ischemia with vascular leakage and optical coherence tomography showed cystoid macular oedema. The patient completed a short-course treatment with high-dose oral steroids. After 1 week, BCVA was 20/20 bilaterally. After 1 month, fundoscopy and imaging evaluation revealed complete resolution of the retinal injury. This favorable outcome remained stable throughout the 1-year follow-up. Conclusions: AND IMPORTANCE: Purtscher-like retinopathy is a rare, sight-threatening retinal disorder. We described a case of retinal injury presumably related to chronic kidney disease and possibly triggered by an influenza-like syndrome, with a favorable visual recovery.

Keywords

• Chronic kidney disease
• Influenza-like syndrome
• Purtscher-like retinopathy
• Retinal microvasculopathy
• Systemic steroids