Title

BILATERAL NEOVASCULARIZATION IN PURTSCHER RETINOPATHY

Summary

A 32 years old white male patient complaining of bilateral progressive low vision. Past medical history: Direct chest trauma after motorcycle accident 4 months ago with ribs and clavicle fractures. No comorbidities, use of medications or drug abuse. Past ophthalmic history: Ophthalmic bed examination 3 weeks after trauma: Suggestive fundoscopic findings of Purtscher retinopathy. (Purtscher flecken, Retinal hemorrhages and cotton-woll spots at the posterior pole and around the optic disc). Later, the patient was referred to complete opthalmological evaluation but lost follow-up. Current ocular examination 4 months after trauma: Best corrected visual acuity of counting fingers in both eyes without findings in the biomicroscopic examination of anterior segment. Intraocular pressure: 12 mmHg (both eyes). Fundus examination: diffuse retinal and optic disc neovascularization, ghost vessels and diffuse arteriolar narrowing, vascular loopings in arch branches, retinal fibrosis and ischemic areas, large areas of vascular occlusion with intravascular deposits, hard exudates on macular topography and pre-retinal hemorrhages in temporal vascular arches. Fluorescein angiography showed significant neovascularization and large areas of retinal ischemia. Based on the clinical history and fundoscopic findings was suggested and confirmed the hypothesis of Purstcher retinopathy complicated with retinal neovascularization. The patient underwent panretinal photocoagulation and maintains regular follow up.

Area

CLINICAL CASE

Authors

IURI CARDOSO SILVA, DELMA REGINA GOMES HUARACHI, ERICK CARNEIRO HOLANDA, VICENTE HIDALGO RODRIGUES FERNANDES, TAIANE KELLY LIMA SILVA, LUISA GRAVE GROSS, MICHEL BEREZOVSKY, MAURICIO ABUJAMRA NASCIMENTO