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Purtscher's retinopathy- a case of bilateral visual loss after chest compression

Poster Details


Co Author(s):    Z. Mavija   V. Jaksic   M. Stamenkovic   E. Ignjatic   S. Smoljanovic   D. Risimic   0   0 0   0 0   0 0   0 0

Abstract Details


A case report of a patient with bilateral Purtscher's retinopathy after traffic accident.


A 62-year-old man with sudden loss of vision in both eyes was admitted as an emergency case to the Ophthalmology Clinic of the Clinical Center of Banjaluka.


We have thoroughly examined the patient and did fundus photography and fluorescein angiography. He gave a history of a recent trauma from an accident with a tractor that overturned on him and compressed his chest. At admission, his visual acuity in both eyes was limited to counting fingers at a half-meter distance. There were no other abnormal findings in the anterior segment apart from semi-mydriatic pupils with poor reaction to light.


We found numerous “cotton-wool” exudates in both ocular fundi as a sentinels of neuronal damage; these were mostly within peri-papillary and inter-papillomacular areas. Our patient had a multiple retinal pale patches as a sign of ischaemia and retinal hemorrhages.


Following acute compression injures to the thorax or head, a patient may experience visual loss due to Purtscher's angiopathic retinopathy in one or both eyes. The mechanism remains unclear and somewhat controversial. Embolization of leukocytes can cause arterial occlusion and infarction of the microvascular bed. Because of its known association with trauma, acute pancreatitis and vascular diseases, leukocyte aggregation by complement C5a is believed to underly microvascular embolization in the eye.

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