PATHOGENESIS AND NEUROPROTECTIVE TREATMENT IN PURTSCHERS-RETINOPATHY

Purtscher's retinopathy is characterized by sudden visual loss in seve rely traumatized patients and is associated with multiple areas of sup erficial retinal whitening located primarily in the posterior pole. Vi sual outcome in Purtscher's retinopathy is variable, and there is no w ell-defined treatment. We report on a patient with immediate blurred v ision in the right eye after a traffic accident. Ophthalmoscopy reveal ed multiple whitish patches scattered over the macular and peripapilla ry areas in the right eye. Fluorescein angiography showed multifocal r etinal arteriolar occlusion in the early phase and staining of the inv olved retinal vessels and optic nerve head in the late phase. Indocyan ine green angiography (ICG) showed rarefaction of choroidal vessels in the peripapillary area of the right eye at early phase. The late phas e ICG study revealed multifocal hypofluorescent patches in the macular and peripapillary areas. Megadose steroid therapy was given with good visual response in the first 2 weeks, and the patient's vision had re covered completely when followed-up 10 months later. Jpn J Ophthalmol 1998;42:318-322 (C) 1998 Japanese Ophthalmological Society.