At the recent RANZCO NZ branch meeting, Nelson Hospital’s Drs Samuel Preston and Sacha Moore’s poster, ‘Blind drunk: vision loss following admission with alcoholic pancreatitis’, detailed a case of Purtscher-like retinopathy in a 50-year-old patient.
Purtscher-like retinopathy is a rare occlusive micro-vasculopathy characterised by distinctive fundoscopic findings, and a history of vision loss, their poster explained. “It shares an underpinning pathophysiology with Purtscher retinopathy, which occurs in the setting of trauma. We report the case of a male admitted with acute alcoholic pancreatitis who developed acute, painless, bilateral visual impairment within the first 24 hours of his hospital admission. Ophthalmic assessment revealed significantly reduced visual acuity bilaterally, severe macular oedema, Purtscher flecken and regions of inner retinal hyper-reflectivity on optical coherence tomography (OCT).”
A diagnosis of Purtscher-like retinopathy was made and discussion with retinal specialists from multiple New Zealand centres resulted in a decision for conservative management only, they said. “The patient was observed to have an almost full visual recovery over the following weeks and a series of fundus photography and OCT scans demonstrated a remarkable return to near-normal retinal anatomy, despite minimal intervention.”
