1. History
  2. Exam
  3. Photos
  4. Diagnosis
  5. Teaching Points
  6. Comments

Case 108 Teaching Points

  • This is a traumatic angiopathy that is typically bilateral in presentation; there is controversy over the existence of unilateral cases
  • Associated with crushing bodily trauma, most notably chest compression
  • There have been several case reports of angiopathy following seat belt trauma; however, the majority involved accidents with multiple injuries from the motor vehicle accident
  • Multiple theories exist regarding the pathogenesis
    • Fat embolization
    • Air embolization
    • Venous reflux
    • Severe angiospastic response
    • Complement-induced granulocyte aggregation
  • Fluorescein angiograms performed early after the trauma may show only arterial staining and leakage; patterns of arteriolar occlusion have also been reported in later angiograms
  • Visual acuities range from 20/200 to finger counting and improve in weeks to months to 20/30 to 20/200

References

Ryan SJ. Retina, 4th ed., Vol 3. Philadelphia:Mosby, 2006, pp 1876-1877.

Kelley JS. Purtscher’s retinopathy related to chest compression by safety belts: fluorescein angiographic findings. Am J Ophthalmol 1972;74:278-283.

Last Modified: Tuesday, 27-May-2008 21:44:10 EDT