title: Purtscher-like retinopathy.
abstract: Purtscher-like retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complement-mediated leukoembolization. It is a rare and severe angiopathy found in conditions such as acute pancreatitis. Case. We present a case of a 53-year-old man who presented with a Purtscher-like retinopathy associated with the development of acute pancreatitis in the context of a Klatskin tumour (a hilar cholangiocarcinoma). The ophthalmologic evaluation revealed the best corrected visual acuity (BCVA) of 20/32 in the right eye (RE) and of 20/40 in the left eye (LE); biomicroscopy of anterior segment showed scleral icterus and fundoscopy revealed peripapillary cotton-wool spots, optic disc edema, and RPE hypo- and hyperpigmentation in the middle peripheral retina in both eyes with an intraretinal hemorrhage in the LE. 15 months after the initial presentation, without ophthalmological treatment, there was an improvement of BCVA to 20/20 in both eyes and optical coherence tomography (OCT) revealed areas of reduction of retinal nerve fiber layer thickness corresponding to the previous cotton-wool spots. Conclusion. Purtscher-like retinopathy should not be neglected in complex clinical contexts. Its unclear pathophysiology determines an uncertain treatment strategy, but a meticulous follow-up is compulsory in order to avoid its severe complications.
authors: Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
authors: Rita
authors: R
authors: Massa
authors: Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
authors: Carolina
authors: C
authors: Vale
authors: Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
authors: Mafalda
authors: M
authors: Macedo
authors: Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
authors: Maria João
authors: MJ
authors: Furtado
authors: Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
authors: Miguel
authors: M
authors: Gomes
authors: Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
authors: Miguel
authors: M
authors: Lume
authors: Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
authors: Angelina
authors: 0000-0001-9148-2786
authors: A
authors: Meireles
references: J Clin Invest. 1979 Apr;63(4):798-803
references: 438338
references: Sao Paulo Med J. 2005 Nov 3;123(6):289-91
references: 16444390
references: Arch Intern Med. 1981 Jan;141(1):134-6
references: 7447575
references: Surv Ophthalmol. 2006 Mar-Apr;51(2):129-36
references: 16500213
references: Br J Ophthalmol. 1982 Apr;66(4):219-26
references: 7066274
references: Ann Ophthalmol. 1993 Sep;25(9):330-3
references: 8297068
references: Arch Soc Esp Oftalmol. 2006 Mar;81(3):161-3
references: 16572360
references: Am J Ophthalmol. 1975 Nov;80(5):935-8
references: 1190285
references: J Fr Ophtalmol. 2008 Jun;31(6 Pt 1):609-13
references: 18772813
references: Br J Ophthalmol. 2007 Nov;91(11):1456-9
references: 17556428
references: Dig Liver Dis. 2000 Nov;32(8):729-32
references: 11142585