A tale of two Purtscher's retinopathy.

ABSTRACT

PURPOSE: To characterize the outcome in two cases of unilateral traumatic Purtscher's retinopathy that developed after blunt head trauma. METHODS: Observational case series of two patients diagnosed at the University of Arkansas for Medical Sciences with Purtscher's retinopathy following blunt head trauma. All patients underwent a comprehensive ophthalmic examination, which included best corrected visual acuity, slit lamp biomicroscopy, dilated fundus exam, and retinal imaging fundus photography and high-definition Spectral domain optical coherence tomography (HD-SDOCT). RESULTS: Two cases of Purtscher's retinopathy after blunt head trauma were diagnosed between July 2011 and December 2011. Case 1 was involved in a motor vehicle accident and underwent observational management with no change in initial baseline vision (20/400) after follow-up of 4 months. Case 2 fell from a 16-foot high deer-stand and managed with systemic steroids, wherein vision improved after one month from 20/60 (initial presentation) to 20/25; vision remained stable after follow-up of 4 months. CONCLUSION: Purtscher's retinopathy can have different visual outcomes depending on the initial and final degree of injury to the retinal architecture. Steroids may help limit damage and improve the overall outcome in patients with Purtscher's retinopathy.