Purtscher Retinopathy
- Multiple microinfarctions of retina
- Evident as cotton wool spots, usually in both eyes
- Presumed antigen-antibody clumping in arterioles with complement release
- Usually only evidence of infarction
- Occurs immediately in severe compressive chest, pelvic, long bone trauma, pancreatitis
- Patient usually reports scotomas
- Scotomatous visual loss in one eye or both
- May impair visual acuity
- Multiple cotton wool spots within temporal vascular arcades of retina
- Scattered retinal hemorrhages sometimes
- Patient (and caregivers) usually preoccupied with non-ophthalmic manifestations
- Refer patient promptly with acute visual complaints in setting of trauma, pancreatitis
- No treatment for this condition, but...
- Referral appropriate to confirm diagnosis
- Cotton wool spots disappear within weeks, but there may be permanent visual loss
