CONTRALATERAL VISION LOSS AFTER ENDONASAL DACRYOCYSTORHINOSTOMY: A CASE REPORT OF PURTSCHER-LIKE RETINOPATHY AND TREATMENT WITH INTRAVITREAL TISSUE PLASMINOGEN ACTIVATOR.
OBJECTIVE
To present a case of a patient with contralateral vision loss as a result of Purtscher-like retinopathy after an endonasal dacryocystorhinostomy and treatment with intravitreal tissue plasminogen activator injection.


RESULTS
A 51-year-old woman who underwent a left endonasal dacryocystorhinostomy was referred with a complaint of decreased vision 1 day after surgery in her right eye. At the initial examination, the visual acuity of her right eye was hand motion. The fundoscopic examination revealed a premacular hemorrhage, diffuse intraretinal hemorrhages, multiple peripapillary cotton wool patches, and Purtscher flecken. The patient received 50 μg/0.1 mL of intravitreal tissue plasminogen activator injection. One day after the injection, visual acuity improved to 3/20. On 1-month follow-up without medication, the visual acuity improved to 6/20, and normal visual evoked potential latencies and amplitudes were detected.


CONCLUSIONS
Purtscher- like retinopathy may occur as a complication of endonasal dacryocystorhinostomy. Intravitreal tissue plasminogen activator may help relieve the embolization that occurs in Purtscher-like retinopathy.
Istanbul Training and Research Hospital, Eye Clinic, Istanbul, Turkey.
Hulya
H
Gungel
Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
Cigdem
C
Altan
Istanbul Training and Research Hospital, Eye Clinic, Istanbul, Turkey.
Belma
B
Karini
Istanbul Training and Research Hospital, Eye Clinic, Istanbul, Turkey.
Fatma E
FE
Ozdemir
Istanbul Training and Research Hospital, Otolaryngology Clinic, Istanbul, Turkey.
Ozlem O
OO
Celebi
D003608:Dacryocystorhinostomy / Q000009:adverse effects*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D008875:Middle Aged; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000188:drug therapy / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator