EC Ophthalmology

Purtscher retinopathy’s (PR) is a rare microvasculopathy often linked to trauma, presenting with sudden vision loss and characteristic retinal findings. We report an unusual case of PR in a 43-year-old female with hypertension, complicated by prior central retinal vein occlusion (CRVO) and the absence of a clear traumatic etiology. The patient initially presented with progressive vision loss, disc edema, cotton wool spots, dilated venules, and retinal hemorrhages, initially diagnosed as CRVO. Following a hypertensive emergency, fundoscopic exam revealed Purtscher flecken, confirming PR. Etiological considerations included embolic events, hypertensive crisis, and the preceding CRVO. Treatment involved topical and systemic corticosteroids, intravitreal bevacizumab, and triamcinolone acetonide. While clinical findings improved with treatment, visual acuity stabilized at 20/150. This case uniquely highlights PR's occurrence without typical trauma, its overlap with CRVO, and the challenges in determining etiology. The combination of steroids and bevacizumab demonstrated anatomical benefits, though visual recovery was limited. This report underscores the importance of considering PR in atypical presentations and the need for further research to optimize treatment strategies for this rare condition.

 Keywords: Purtscher’s Retinopathy; Purtscher-Like Retinopathy; Central Retinal Vein Occlusion; Purtscher Flecken; Macular Edema

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